Provider Demographics
NPI:1013622950
Name:OPTOMETRY EYECARE ON THE AVENUE PLLC
Entity Type:Organization
Organization Name:OPTOMETRY EYECARE ON THE AVENUE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEACE
Authorized Official - Middle Name:CHINONYEREM
Authorized Official - Last Name:ANYADIKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-348-4280
Mailing Address - Street 1:1 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-1511
Mailing Address - Country:US
Mailing Address - Phone:914-348-4280
Mailing Address - Fax:
Practice Address - Street 1:243 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2602
Practice Address - Country:US
Practice Address - Phone:914-348-4280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty