Provider Demographics
NPI:1780765115
Name:STRELZYN, MARJORIE T (OD)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:T
Last Name:STRELZYN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COURTMEL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3900
Mailing Address - Country:US
Mailing Address - Phone:718-654-0023
Mailing Address - Fax:
Practice Address - Street 1:COLLEGE EYE INSTITUTE
Practice Address - Street 2:1500 ASTOR AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469
Practice Address - Country:US
Practice Address - Phone:718-654-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT004719152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist