Provider Demographics
NPI:1700540077
Name:NEW YORK EYE AND GLAUCOMA SPECIALIST PLLC
Entity Type:Organization
Organization Name:NEW YORK EYE AND GLAUCOMA SPECIALIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YUFEI
Authorized Official - Middle Name:
Authorized Official - Last Name:TU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-724-1896
Mailing Address - Street 1:42 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1029
Mailing Address - Country:US
Mailing Address - Phone:347-724-1896
Mailing Address - Fax:410-657-6888
Practice Address - Street 1:13636 39TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5576
Practice Address - Country:US
Practice Address - Phone:646-530-8400
Practice Address - Fax:410-657-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-23
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255607206OtherNPI NUMBER