Provider Demographics
NPI:1033117999
Name:PRYWES, ARNOLD S (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:S
Last Name:PRYWES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E GATE BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2124
Mailing Address - Country:US
Mailing Address - Phone:516-804-5200
Mailing Address - Fax:516-731-4805
Practice Address - Street 1:4212 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714
Practice Address - Country:US
Practice Address - Phone:516-731-4800
Practice Address - Fax:516-731-4805
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116342207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12824Medicare UPIN
NY317001Medicare ID - Type Unspecified