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Organization

MA OPHTHALMOLOGY, PLLC

Active
Parent organization
MA OPHTHALMOLOGY, PLLC
Other names
Envision Eye Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
MA OPHTHALMOLOGY, PLLC
Authorized official
DR. LAIYIN MA MD (OWNER)
(917) 667-2655
Entity
Organization

Contact information

Practice address
3616 MAIN ST FL 9, FLUSHING, NY 11354-4105
(917) 667-2655
Mailing address
69 EAKINS RD, MANHASSET, NY 11030-2632
(917) 667-2655

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05763199
NY
Enumeration date
05/25/2021
Last updated
08/02/2022
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