Provider Demographics
NPI:1730927062
Name:AMANDA P HORDOS OD PLLC
Entity type:Organization
Organization Name:AMANDA P HORDOS OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:HORDOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:631-877-0651
Mailing Address - Street 1:11 MAHAN RD
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1213
Mailing Address - Country:US
Mailing Address - Phone:631-877-0651
Mailing Address - Fax:
Practice Address - Street 1:150 SUNNYSIDE BLVD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1504
Practice Address - Country:US
Practice Address - Phone:631-877-0651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty