| NPI | 1003973223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS T BERGER Mgr 718-409-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY VUT002933-1) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: NY VUT002933-1) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: NY VUT002933-1) | |
| 152WS0006X Optometrist Sports Vision (Licence: NY VUT002933-1) | |
| 152WX0102X Optometrist Occupational Vision (Licence: NY VUT002933-1) | |
| 156FC0800X Technician/Technologist Contact Lens (Licence: NY 005104-1) | |
| 156FC0801X Technician/Technologist Contact Lens Fitter (Licence: NY 005104-1) | |
| 156FX1800X Technician/Technologist Optician (Licence: NY 005104-1) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-01-28 |