Individual
DR. CRAIG BRIAN TISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
244 WEST 54TH STREET, SUITE 402, NEW YORK, NY 10019
(212) 765-2660
(212) 765-2714
Mailing address
244 WEST 54TH STREET, SUITE 402, NEW YORK, NY 10019
(212) 765-2660
(212) 765-2714
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005672
NY
152W00000X
Optometrist
TUV005672-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01618693
—
NY
05
—
01777128
—
NY
01
—
C03651
PTAN
NY
Enumeration date
11/28/2006
Last updated
08/02/2022
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