Provider Demographics
NPI:1376724302
Name:FZOAD COM ENTERPRISES INC
Entity type:Organization
Organization Name:FZOAD COM ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-243-5898
Mailing Address - Street 1:247 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2302
Mailing Address - Country:US
Mailing Address - Phone:212-243-5898
Mailing Address - Fax:
Practice Address - Street 1:247 W 23RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2302
Practice Address - Country:US
Practice Address - Phone:212-243-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100001453Medicare PIN