Organization
VISUAL OPHTHALMOLOGY SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PANUS ROMSAITONG MD (MEDICAL DIRECTOR)
(718) 271-4472
Entity
Organization
Contact information
Practice address
5548 96TH ST, CORONA, NY 11368-3009
(718) 271-4472
(718) 271-3011
Mailing address
5548 96TH ST, CORONA, NY 11368-3009
(718) 271-4472
(718) 271-3011
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
209009
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01914878
—
NY
Enumeration date
10/31/2016
Last updated
11/02/2022
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