Organization
COMPREHENSIVE EYECARE AND SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN J ICASIANO (PHYSICIAN)
(917) 334-7907
Entity
Organization
Contact information
Practice address
500 CENTRAL AVE, # 220, UNION CITY, NJ 07087-5302
(917) 334-7907
Mailing address
450 W 17TH ST, #711, NEW YORK, NY 10011-5811
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
243702
NY
207W00000X
Ophthalmology Physician
Primary
25MA08227200
NJ
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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