Provider Demographics
NPI:1184328155
Name:DAVIS EYE CARE AND OPTICAL
Entity type:Organization
Organization Name:DAVIS EYE CARE AND OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARWAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KASSIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:347-294-9853
Mailing Address - Street 1:1859 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4904
Mailing Address - Country:US
Mailing Address - Phone:347-294-9853
Mailing Address - Fax:
Practice Address - Street 1:68 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6647
Practice Address - Country:US
Practice Address - Phone:347-294-9853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty