| NPI | 1114124633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR VALERY SUPITSKIY President 718-648-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV006530-1) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2009-04-21 |