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Provider Information for 1376941583

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

GREENPOINT EYE CARE LLC

Organization Subpart: NO

Organization NPI: 1376941583

Calendar   Last Updated:  2014-12-22
  Certification Date: 

Details

Name Value
NPI 1376941583
Enumeration Date 2014-12-22
NPI Type 2- Organization
Status Active
Authorized Official Information Name: DR. MICHAEL KISELOW O.D.
Title: OWNER
Phone: 718-389-0333
Mailing Address 909 MANHATTAN AVE
BROOKLYN, NY 11222-5960
United States

Phone: 718-389-0333 | Fax: 718-389-0400
View Map External Link
Primary Practice Address 909 MANHATTAN AVE
BROOKLYN, NY 11222-5960
United States

Phone: 718-389-0333 | Fax: 718-389-0400
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 02896642
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193200000X MULTI-SPECIALTY GROUP
152W00000X - Optometrist
NY TUV006648-01