Provider Demographics
NPI:1841335304
Name:MARGOLIN, HOWARD JAY (OD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JAY
Last Name:MARGOLIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BEACON LN
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5401
Mailing Address - Country:US
Mailing Address - Phone:631-266-5942
Mailing Address - Fax:
Practice Address - Street 1:91 BROADWAY
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3234
Practice Address - Country:US
Practice Address - Phone:516-593-2888
Practice Address - Fax:516-593-7106
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005195152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC2A34CBNH1Medicare ID - Type Unspecified
NYU45928Medicare UPIN