Provider Demographics
NPI:1881864957
Name:NORTHERN WESTCHESTER OPHTHALMOLOGY
Entity Type:Organization
Organization Name:NORTHERN WESTCHESTER OPHTHALMOLOGY
Other - Org Name:GLASSMAN OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:ABO
Authorized Official - Phone:914-243-7920
Mailing Address - Street 1:1940 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4428
Mailing Address - Country:US
Mailing Address - Phone:914-243-7920
Mailing Address - Fax:914-962-0877
Practice Address - Street 1:1940 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4428
Practice Address - Country:US
Practice Address - Phone:914-243-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN WESTCHESTER OPHTHALMOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-05
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108613332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400006855Medicare PIN
NY6603390001Medicare NSC