# BRONX OPHTHALMOLOGIC, PC

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

## Provider details

- **NPI number:** 1962531046
- **Authorized official:** GENE MATUSOW M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (914) 654-6543

## Contact information

- **Practice address:** 4422 3RD AVE, BRONX, NY 10457-2545
- **Practice address phone:** (914) 654-6543
- **Mailing address:** 4422 3RD AVE, BRONX, NY 10457-2545
- **Mailing address phone:** (914) 654-6543

## Taxonomy

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

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 06/24/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02128009 | — | NY |