Basic Information
| Provider Information | |||||||||
| NPI: | 1649306218 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARK D FROMER, MD PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FROMER EYE CENTERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10933 71ST RD | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113754850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182613366 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10933 71ST RD | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113754850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182613366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 01/08/2009 | ||||||||
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| AuthorizedOfficialLastName: | FROMER | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT-CEO | ||||||||
| AuthorizedOfficialTelephone: | 2128329228 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.