| NPI | 1164165999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM KARUSO Director Of Credentialing 646-660-1993 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2024-03-07 |