Provider Demographics
NPI:1972785863
Name:WOODCLIFF LAKE OPHTHALMOLOGY, LLP.
Entity Type:Organization
Organization Name:WOODCLIFF LAKE OPHTHALMOLOGY, LLP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:YASHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-782-1700
Mailing Address - Street 1:577 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-8409
Mailing Address - Country:US
Mailing Address - Phone:973-782-1700
Mailing Address - Fax:201-782-1749
Practice Address - Street 1:577 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-8409
Practice Address - Country:US
Practice Address - Phone:973-782-1700
Practice Address - Fax:201-782-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1972785863Medicare NSC