Provider Demographics
NPI:1780710087
Name:NEW YORK CITY OPHTHALMOLOGY, P.C.
Entity type:Organization
Organization Name:NEW YORK CITY OPHTHALMOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-875-1744
Mailing Address - Street 1:142 JORALEMON ST STE 10B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4709
Mailing Address - Country:US
Mailing Address - Phone:718-875-1744
Mailing Address - Fax:718-875-1744
Practice Address - Street 1:142 JORALEMON ST STE 10B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4709
Practice Address - Country:US
Practice Address - Phone:718-875-1744
Practice Address - Fax:718-875-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205547207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01913735Medicaid
NY01913735Medicaid