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Organization
COASTAL EYE SURGERY CENTER PLLC
Active
Organization
COASTAL EYE SURGERY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR SHAKIR MD MBA (PRESIDENT)
(203) 900-7911
Entity
Organization
Contact information
Practice address
600 W PUTNAM AVE LOWR LEVEL, GREENWICH, CT 06830-6080
(203) 900-7911
(203) 900-7911
Mailing address
600 W PUTNAM AVE LOWR LEVEL, GREENWICH, CT 06830-6080
(203) 900-7911
(203) 900-7911
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
NULL
Other
Enumeration date
02/19/2021
Last updated
02/23/2021
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