# PETROU-HAEFS EYECARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Petrou Eye Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891068599
- **Authorized official:** DR. CHRISTINA PETROU OD (OPTOMETRIST)
- **Authorized official phone:** (414) 839-8379

## Contact information

- **Practice address:** 7040 N PORT WASHINGTON RD, SUITE 420, GLENDALE, WI 53217-3885
- **Practice address phone:** (414) 839-8379
- **Mailing address:** 7040 N PORT WASHINGTON RD, SUITE 420, GLENDALE, WI 53217-3885
- **Mailing address phone:** (414) 839-8379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 2387-035 | WI | Yes |

## Other

- **Enumeration date:** 02/12/2012
- **Last updated:** 02/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 385755400 | — | WI |