Provider Demographics
NPI:1891047494
Name:ANKOLA, PRASHANT D (OD)
Entity Type:Individual
Prefix:DR
First Name:PRASHANT
Middle Name:D
Last Name:ANKOLA
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:55 WATER STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:1050 CLOVE ROAD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301
Practice Address - Country:US
Practice Address - Phone:718-816-6440
Practice Address - Fax:718-420-2718
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY007891152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist