Provider Demographics
NPI:1336454495
Name:ADVANCE SIGHT EYECARE MEDICAL PC
Entity Type:Organization
Organization Name:ADVANCE SIGHT EYECARE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:NAING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-966-7583
Mailing Address - Street 1:PO BOX 1336
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-0962
Mailing Address - Country:US
Mailing Address - Phone:212-966-7583
Mailing Address - Fax:212-966-7582
Practice Address - Street 1:128 MOTT ST
Practice Address - Street 2:SUITE 303
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5540
Practice Address - Country:US
Practice Address - Phone:212-966-7583
Practice Address - Fax:212-966-7582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213366207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02080124Medicaid
NYH16572Medicare UPIN
NY02080124Medicaid