Provider Demographics
NPI:1972532778
Name:GLENS FALLS EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:GLENS FALLS EYE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:HITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-793-0331
Mailing Address - Street 1:535 BAY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-3018
Mailing Address - Country:US
Mailing Address - Phone:518-793-0331
Mailing Address - Fax:518-793-7986
Practice Address - Street 1:535 BAY RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804
Practice Address - Country:US
Practice Address - Phone:518-793-0331
Practice Address - Fax:518-793-7986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39071AMedicare ID - Type Unspecified