Provider Demographics
NPI:1730230533
Name:SVITRA, PAUL P (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:P
Last Name:SVITRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:320 E SHORE RD APT 29C
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1737
Mailing Address - Country:US
Mailing Address - Phone:516-273-0404
Mailing Address - Fax:
Practice Address - Street 1:1055 FRANKLIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2903
Practice Address - Country:US
Practice Address - Phone:516-327-0505
Practice Address - Fax:516-393-2155
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2025-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1819851207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01276851Medicaid
NYE12650Medicare UPIN
NY59F862Medicare ID - Type Unspecified