Provider Demographics
NPI:1669478699
Name:GETZ, DANA L (OD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:L
Last Name:GETZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DANA
Other - Middle Name:L
Other - Last Name:GETZ-GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:27130 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1446
Mailing Address - Country:US
Mailing Address - Phone:718-343-1414
Mailing Address - Fax:718-343-2578
Practice Address - Street 1:27130 77TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1446
Practice Address - Country:US
Practice Address - Phone:718-343-1414
Practice Address - Fax:718-343-2578
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0043531152W00000X
CAOPT7808152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC42291OtherEMPIRE
NY0004554002OtherAETNA USHEALTHCARE PIN (NONHMO PROVIDER IDENTIFICATION NUMBER)
NY0597512OtherAETNA USHEALTHCARE PVN (HMO LEGACY #)
NYC42292OtherEMPIRE/MEDICARE
NY3C2931OtherGUARDIAN HEALTHNET
NY06950GMedicare PIN
NY25389Medicare PIN
NY0004554002OtherAETNA USHEALTHCARE PIN (NONHMO PROVIDER IDENTIFICATION NUMBER)