Provider Demographics
NPI:1356527568
Name:ANNETTE KIRSZROT, BCO OCULAR PROSTHETICS, INC.
Entity type:Organization
Organization Name:ANNETTE KIRSZROT, BCO OCULAR PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSZROT, BCO
Authorized Official - Suffix:
Authorized Official - Credentials:BCO
Authorized Official - Phone:212-595-0520
Mailing Address - Street 1:174 W 76TH ST
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-8404
Mailing Address - Country:US
Mailing Address - Phone:212-595-0520
Mailing Address - Fax:212-580-0711
Practice Address - Street 1:174 W 76TH ST
Practice Address - Street 2:SUITE 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-8404
Practice Address - Country:US
Practice Address - Phone:212-595-0520
Practice Address - Fax:212-580-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3400773OtherGHI
NYA1970769OtherOXFORD
NY01189817Medicaid
NYC 81401OtherEMPIRE BC/BS
NY0335540001Medicare NSC