Paola Jelena Burburan, OD

Individual provider Active NPI Optometrist · North New Hyde Park, NY

NPI 1154962744 · NPPES record last updated Oct 4, 2019

Key facts

NPI
1154962744
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
009043-01 (NY)
Practice address
1981 Marcus Ave Ste E115
North New Hyde Park, NY 11042-1038
Phone
(516) 627-5113
NPI assigned
Oct 4, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
009043-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Eye Surgeons, PC Current
since Oct 6, 2019
Accepting new patients

Locations

1981 Marcus Ave
Ste E115
North New Hyde Park, NY 11042
Phone (516) 627-5113

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009043-01 NY Yes

Addresses

Primary practice location

1981 Marcus Ave Ste E115
North New Hyde Park, NY 11042-1038

Mailing address

1981 Marcus Ave Ste E115
North New Hyde Park, NY 11042-1038
Phone (516) 627-5113

Other providers in North New Hyde Park, NY

All providers in North New Hyde Park, NY · Optometrist in New York

Sources for this page

Verify at the official NPI Registry.