Provider Demographics
NPI:1548886260
Name:BARTOW OPHTHALMOLOGY PLLC
Entity type:Organization
Organization Name:BARTOW OPHTHALMOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ASSUMPTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-556-9673
Mailing Address - Street 1:2100 BARTOW AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 BARTOW AVE STE 208
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4614
Practice Address - Country:US
Practice Address - Phone:203-556-9673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty