Provider Demographics
NPI:1669743787
Name:VITRORETINAL AND UVEITIS SERVICES
Entity type:Organization
Organization Name:VITRORETINAL AND UVEITIS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAPOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-845-4400
Mailing Address - Street 1:8212 151ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1793
Mailing Address - Country:US
Mailing Address - Phone:718-845-4400
Mailing Address - Fax:
Practice Address - Street 1:8212 151ST AVE
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1793
Practice Address - Country:US
Practice Address - Phone:718-845-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty