| NPI | 1235242553 |
|---|---|
| Former Legal Business Name | VITREORETINAL CONSULTANTS PC |
| Entity Type | Organization |
| Authorized Contact | DAVID M FASTENBERG Authorized Official 516-466-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-02-13 |