Provider Demographics
NPI:1699979930
Name:METROPOLITAN EYE SURGERY, PC
Entity type:Organization
Organization Name:METROPOLITAN EYE SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-204-6667
Mailing Address - Street 1:4207 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2910
Mailing Address - Country:US
Mailing Address - Phone:718-204-6667
Mailing Address - Fax:718-956-8514
Practice Address - Street 1:4207 30TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2910
Practice Address - Country:US
Practice Address - Phone:718-204-6667
Practice Address - Fax:718-956-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136859207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00593137Medicaid
NYDS233OtherOXFORD HEALTH PLAN
NY52396Medicare ID - Type UnspecifiedMEDICARE GHI
NYDS233OtherOXFORD HEALTH PLAN
NY46A56Medicare ID - Type UnspecifiedMEDICARE BCBS