Provider Demographics
NPI:1154593564
Name:NORTH BRONX RETINAL AND OPHTHALMIC SURGERY PC
Entity type:Organization
Organization Name:NORTH BRONX RETINAL AND OPHTHALMIC SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHECHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-535-4932
Mailing Address - Street 1:3725 HENRY HUDSON PKWY
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1527
Mailing Address - Country:US
Mailing Address - Phone:347-535-4932
Mailing Address - Fax:
Practice Address - Street 1:3725 HENRY HUDSON PKWY
Practice Address - Street 2:SUITE 1-D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1527
Practice Address - Country:US
Practice Address - Phone:347-535-4932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212003-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty