Provider Demographics
NPI:1134413693
Name:ADVANCED OPHTHALMOLOGY, PC
Entity type:Organization
Organization Name:ADVANCED OPHTHALMOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YONAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMLET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-327-3200
Mailing Address - Street 1:220 BEACH 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3618
Mailing Address - Country:US
Mailing Address - Phone:718-327-3200
Mailing Address - Fax:718-327-3505
Practice Address - Street 1:220 BEACH 20TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3618
Practice Address - Country:US
Practice Address - Phone:718-327-3200
Practice Address - Fax:718-327-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134709207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty