Provider Demographics
NPI:1891383592
Name:HICKSVILLE OPTOMETRY PC
Entity Type:Organization
Organization Name:HICKSVILLE OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:646-734-6367
Mailing Address - Street 1:358B BROADWAY MALL STE 881
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2709
Mailing Address - Country:US
Mailing Address - Phone:516-938-6006
Mailing Address - Fax:516-513-0156
Practice Address - Street 1:358B BROADWAY MALL STE 881
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2709
Practice Address - Country:US
Practice Address - Phone:516-938-6006
Practice Address - Fax:516-513-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty