Provider Demographics
NPI:1427150200
Name:KANARFOGEL, DEBORAH KARMEL (OD)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:KARMEL
Last Name:KANARFOGEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 E 116TH ST
Mailing Address - Street 2:WIZARD OF EYES
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-1342
Mailing Address - Country:US
Mailing Address - Phone:212-996-7676
Mailing Address - Fax:
Practice Address - Street 1:187 E 116TH ST
Practice Address - Street 2:WIZARD OF EYES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-1342
Practice Address - Country:US
Practice Address - Phone:212-996-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT003879-1152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01038173Medicaid
NYT49065Medicare UPIN
NYC32721Medicare ID - Type Unspecified