Provider Demographics
NPI:1669625620
Name:PAZOS, DAVID (OPHTHALMIC DISPENSER)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:PAZOS
Suffix:
Gender:M
Credentials:OPHTHALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 PARSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3049
Mailing Address - Country:US
Mailing Address - Phone:718-380-7788
Mailing Address - Fax:718-380-7788
Practice Address - Street 1:7051 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-3049
Practice Address - Country:US
Practice Address - Phone:718-380-7788
Practice Address - Fax:718-380-7788
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008847-1156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic