| NPI | 1154594190 |
|---|---|
| Doing Business As | BAY STREET OPTICAL PAVILION |
| Entity Type | Organization |
| Authorized Contact | CAROLYN ROSEMARY POWELL RIVERS Principle 718-727-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV004813-1) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |