Long Island Vitreo Retinal Consultants PC
Ophthalmology, Retina Specialist in Elmhurst, NY. Organization (NPI-2).
NPI number1235242553
StatusActive
Last updated in NPPESJul 23, 2026
Details
- NPI
- 1235242553
- Entity type
- Organization (NPI-2)
- Legal business name
- Long Island Vitreo Retinal Consultants PC
- Organization subpart
- No
- Enumeration date
- Aug 17, 2006
- Certification date
- Jul 23, 2026
- Last updated
- Jul 23, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207WX0107X | Ophthalmology, Retina Specialist | – | – | Yes |
| 207W00000X | Ophthalmology | – | – |
Other names
- Vitreoretinal Consultants PC (Former Legal Business Name)
Practice location
9131 Queens BlvdSuite 209
Elmhurst, NY 11373-5555
Phone 718-793-6430 · Fax 718-793-6321
Mailing address
9131 Queens Blvd Ste 209Elmhurst, NY 11373-5511
Phone 718-793-6430 · Fax 718-793-6321
Authorized official
Kenneth B Graham
Owner
5164660390
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