Provider Demographics
NPI:1720529712
Name:COMPREHENSIVE OPTOMETRY EYE CARE
Entity Type:Organization
Organization Name:COMPREHENSIVE OPTOMETRY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELLIOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-482-2863
Mailing Address - Street 1:21431 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1231
Mailing Address - Country:US
Mailing Address - Phone:917-482-2863
Mailing Address - Fax:
Practice Address - Street 1:21431 51ST AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE HILLS
Practice Address - State:NY
Practice Address - Zip Code:11364-1231
Practice Address - Country:US
Practice Address - Phone:917-482-2863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty