| NPI | 1043342967 |
|---|---|
| Doing Business As | EYE SUPPLY OF BAY SHORE |
| Entity Type | Organization |
| Authorized Contact | NICK RUSSO Owner 631-666-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY NY TUV006870-1) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |