| Greater New York Ophthalmology Care, Pllc | |
|
4141 51st St Woodside NY 11377-4431 | |
| (718) 505-0100 | |
| (717) 505-0101 |
| Full Name | Greater New York Ophthalmology Care, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4141 51st St, Woodside, New York |
| Authorized Official Name and Position | Benjamin Fateh Mason (MEMBER) |
| Authorized Official Contact | 7184906522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater New York Ophthalmology Care, Pllc 4141 51st St Woodside NY 11377-4431 Ph: (718) 505-0100 | Greater New York Ophthalmology Care, Pllc 4141 51st St Woodside NY 11377-4431 Ph: (718) 505-0100 |
| NPI Number | 1629278643 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 07/18/2007 |
| Medicare PECOS PAC ID | 2466591839 |
|---|---|
| Medicare Enrollment ID | O20091124000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629278643 | NPI | - | NPPES |
| 1356390488 | Other | NY | NPI |
| 02802091 | Medicaid | NY | |
| 07759 | Other | NY | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 224032 (New York) | Primary |
| Provider Name | Benjamin Mason |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1356390488 PECOS PAC ID: 0042237299 Enrollment ID: I20060623000215 |
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