Provider Demographics
NPI:1023121456
Name:KAPLAN, EVAN N (OD, MS)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:N
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 CROSBY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4902
Mailing Address - Country:US
Mailing Address - Phone:718-792-2020
Mailing Address - Fax:718-792-9415
Practice Address - Street 1:1748 CROSBY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4902
Practice Address - Country:US
Practice Address - Phone:718-792-2020
Practice Address - Fax:718-792-9415
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005119152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01492373Medicaid
NY0592240001OtherDURABLE MEDICAL EQUIPMENT
NY01492373Medicaid
NY0592240001OtherDURABLE MEDICAL EQUIPMENT