Christy Park, OD | |
15 Division St, New York, NY 10002-6710 | |
(718) 676-9841 | |
Not Available |
Full Name | Christy Park |
---|---|
Gender | Female |
Speciality | Optometrist |
Location | 15 Division St, New York, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972225290 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TUV009614-01 (New York) | Primary |
Provider Name | Swdj Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1154024768 PECOS PAC ID: 9133584220 Enrollment ID: O20230425000254 |
Mailing Address | Practice Location Address |
---|---|
Christy Park, OD 15 Division St, New York, NY 10002-6710 Ph: (718) 676-9841 | Christy Park, OD 15 Division St, New York, NY 10002-6710 Ph: (718) 676-9841 |
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