Provider Demographics
NPI:1255700118
Name:COMPLETE OPTOMETRY CARE PC
Entity type:Organization
Organization Name:COMPLETE OPTOMETRY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISSOON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-412-2287
Mailing Address - Street 1:12015 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2117
Mailing Address - Country:US
Mailing Address - Phone:718-843-2156
Mailing Address - Fax:
Practice Address - Street 1:12015 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2117
Practice Address - Country:US
Practice Address - Phone:718-843-2156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007180152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty