# NORTH SHORE RETINA PHYSICIAN, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548566342
- **Authorized official:** MRS. NAZANIN BARZIDEH MD (PHYSICIAN)
- **Authorized official phone:** (516) 729-8515

## Contact information

- **Practice address:** 300 OLD COUNTRY RD, SUITE GL 51, MINEOLA, NY 11501-4198
- **Practice address phone:** (516) 729-8515
- **Practice address fax:** (516) 277-1528
- **Mailing address:** 74 FINCH DR, ROSLYN, NY 11576-2705
- **Mailing address phone:** (516) 729-8515
- **Mailing address fax:** (516) 277-1528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 226005 | NY | Yes |

## Other

- **Enumeration date:** 01/27/2011
- **Last updated:** 01/27/2011