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Organization

VINCENT P BASILICE M D P C

Active
Other names
The Ophthalmic Center
Organization subpart
No

Provider details

NPI number
Authorized official
VINCENT PRESCOTT BASILICE MD (MEDICAL DIRECTOR/ PRESIDENT)
(631) 751-2020
Entity
Organization

Contact information

Practice address
3400 NESCONSET HWY, SUITE 107, EAST SETAUKET, NY 11733-3327
(631) 751-2020
(631) 751-0048
Mailing address
3400 NESCONSET HWY, SUITE 107, EAST SETAUKET, NY 11733-3327
(631) 751-2020
(631) 751-0048

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
4104
NY
152W00000X
Optometrist
TUV005780-1
NY
207W00000X
Ophthalmology Physician
Primary
127126
NY
207W00000X
Ophthalmology Physician
187993
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00417469
NY
01
441181927
RAILROAD MEDICARE
NY
Enumeration date
07/31/2006
Last updated
10/07/2020
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