Provider Demographics
NPI:1952712382
Name:PLESSEN EYE, LLC
Entity Type:Organization
Organization Name:PLESSEN EYE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:BIJAN
Authorized Official - Last Name:TAWAKOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-715-7720
Mailing Address - Street 1:3004 ORANGE GROVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4288
Mailing Address - Country:US
Mailing Address - Phone:340-715-7720
Mailing Address - Fax:340-713-9002
Practice Address - Street 1:5 ORANGE GROVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-715-7720
Practice Address - Fax:340-713-9002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLESSEN HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-20
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI207L00000X, 208600000X, 261QA1903X, 261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1457775785OtherNPI