1013011105 NPI number — OPHTHALMIC CONSULTANTS CORNEAL AND REFRACTIVE SURGERY ASSOCIATES PC

Table of content: MISS EMMA HAMILTON NICHOLLS B.A. (NPI 1699803072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013011105 NPI number — OPHTHALMIC CONSULTANTS CORNEAL AND REFRACTIVE SURGERY ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPHTHALMIC CONSULTANTS CORNEAL AND REFRACTIVE SURGERY ASSOCIATES PC
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:
OPHTHALMIC CONSULTANTS PC
Provider Other Organization Name Type Code:
5
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:
1013011105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 EAST 14TH STREET
Provider Second Line Business Mailing Address:
2ND FLOOR SOUTH BUILDING
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-505-6550
Provider Business Mailing Address Fax Number:
212-979-1772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 EAST 14TH STREET
Provider Second Line Business Practice Location Address:
2ND FLOOR SOUTH BUILDING
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-505-6550
Provider Business Practice Location Address Fax Number:
212-979-1772
Provider Enumeration Date:
09/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAY
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
G
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
212-505-6550

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01759920 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: CB1767 . This is a "PALMETTO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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