1982646766 NPI number — FLATBUSH EYECARE ASSOCIATES INC.

Table of content: (NPI 1982646766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982646766 NPI number — FLATBUSH EYECARE ASSOCIATES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLATBUSH EYECARE ASSOCIATES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982646766
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1137 E 23RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11210-4518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-338-0435
Provider Business Mailing Address Fax Number:
718-338-2573

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1137 E 23RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11210-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-338-0435
Provider Business Practice Location Address Fax Number:
718-338-2573
Provider Enumeration Date:
06/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FINK
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTICIAN
Authorized Official Telephone Number:
718-338-0435

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  5542 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3C0672 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 901018 . This is a "BLOCK VISION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2514355 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6599784 . This is a "G.H.I." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2398318 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 49716284 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: C147D1 . This is a "EMPIRE BLUE CROSS BLUE SH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7398219 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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