Organization
COASTAL EYE SURGERY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR SHAKIR MD MBA (PRESIDENT)
(203) 900-7911
Entity
Organization
Contact information
Practice address
600 W PUTNAM AVE LOWR LEVEL, GREENWICH, CT 06830-6080
(203) 900-7911
(203) 900-7911
Mailing address
600 W PUTNAM AVE LOWR LEVEL, GREENWICH, CT 06830-6080
(203) 900-7911
(203) 900-7911
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
02/19/2021
Last updated
02/23/2021
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