| NPI | 1760736888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN J ICASIANO Physician 917-334-7907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA08227200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 243702) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |