Ettenson, John S

Ettenson, John S is an individual health care provider with primary practice located at 1 Theall Rd , Rye NY 10580-1404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Ettenson, John S can be contacted via phone (914) 848-8800.

Contact Information

Primary practice address
1 Theall Rd Rye NY 10580-1404
Phone: (914) 848-8800
Fax: (914) 682-6403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 174308-1 New York
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 041999 Connecticut

Profile Details

NPI number 1396714820
LBN Legal business name Ettenson, John S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Oct 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396714820 NPPES
New York MEDICAID 01072893
New York Other 21E601
New York Other 133757245

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