Ellvin John Mar (NPI# 1790965101, PAC ID# 1355415035) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1790965101 |
| PAC ID by PECOS | 1355415035 |
| Professional Enrollment ID | I20140728001695 |
| Full Name | Ellvin John Mar |
| Organization Legal Name | TAN AND MAR OPTOMETRY |
| Address |
834 D Fort Salonga Rd Northport NY 11768-3157 |
| Phone Number | 6317574440 |
| Gender | M |
| Medical School | STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY |
| Graduation Year | 2007 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 1557689635 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 834 D Fort Salonga Rd, Northport, NY 11768-3157 | 6317574440 | TAN AND MAR OPTOMETRY |
| Organization Legal Name | TAN AND MAR OPTOMETRY |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Grace Tan | Optometry | Tan and Mar Optometry | 834 D Fort Salonga Rd, Northport, NY 11768-3157 |
| Street Address |
834 D FORT SALONGA RD |
| City | NORTHPORT |
| State | NY |
| Zip | 11768-3157 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Grace Tan | Optometry | Tan and Mar Optometry | 834 D Fort Salonga Rd, Northport, NY 11768-3157 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roger T Kallhovd | Psychiatry | 114 Soundview Ter, Northport, NY 11768-1230 | |
| Holly W Gotta | Clinical Social Worker | 25 Hayes Hill Dr, Northport, NY 11768-1331 | |
| Richard Gotta | Psychologist, Clinical | 25 Hayes Hill Dr, Northport, NY 11768-1331 | |
| Andrew J Rochman | General Surgery | 5 Pebble Hill Dr, Northport, NY 11768-1353 | |
| Christopher Conrad | Physical Therapy | Team Rehab Physical Therapy PC | 10 Fort Salonga Rd, Suite 2a, Fort Salonga, NY 11768-1400 |
| Jennifer L Olsen | Physical Therapy | Team Rehab Physical Therapy PC | 10 Fort Salonga Rd, Suite 2a, Fort Salonga, NY 11768-1400 |
| Eric S Postal | Diagnostic Radiology | Geisinger Clinic | 30 Allenby Dr, Northport, NY 11768-1421 |
| Bilal A Khan | Physical Medicine and Rehabilitation | 12 Beach Hill Dr, Northport, NY 11768-1424 | |
| Laura L Marr | Clinical Social Worker | 103 Fort Salonga Rd, Suite 16, Northport, NY 11768-1454 | |
| Sharon Goldblum | Clinical Social Worker | 103 Fort Salonga Rd, Northport, NY 11768-1454 | |
| Find all physicians in zip 11768 | |||
| City | NORTHPORT |
| Zip Code | 11768 |
| Specialty | OPTOMETRY |
| City + Specialty | NORTHPORT + OPTOMETRY |
Please comment or provide details below to improve the information on Ellvin John Mar.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.