| NPI | 1134736945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S WILLIAMS Authorized Official / Owner 631-422-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-12-03 |