Provider Demographics
NPI:1245363290
Name:NEW YORK LASER EYE LLP
Entity type:Organization
Organization Name:NEW YORK LASER EYE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNERSHIP
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-832-2020
Mailing Address - Street 1:406 15TH ST
Mailing Address - Street 2:SUITE M1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6054
Mailing Address - Country:US
Mailing Address - Phone:718-832-2020
Mailing Address - Fax:
Practice Address - Street 1:406 15TH ST
Practice Address - Street 2:SUITE M1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6054
Practice Address - Country:US
Practice Address - Phone:718-832-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02573619Medicaid
NY02573619Medicaid