Provider Demographics
NPI:1902999279
Name:ALEXANDER TARNARIDER O.D.,P.C.
Entity Type:Organization
Organization Name:ALEXANDER TARNARIDER O.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:TARNARIDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-616-1600
Mailing Address - Street 1:319 BRIGHTON BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7412
Mailing Address - Country:US
Mailing Address - Phone:718-616-1600
Mailing Address - Fax:718-616-0082
Practice Address - Street 1:319 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7412
Practice Address - Country:US
Practice Address - Phone:718-616-1600
Practice Address - Fax:718-616-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-01
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005462152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03108610Medicaid
NY1118930001Medicare NSC
NYC3W601Medicare PIN