| NPI | 1164518577 |
|---|---|
| Doing Business As | VISION PALACE |
| Entity Type | Organization |
| Authorized Contact | IGOR VALERY SUPITSKIY President 718-998-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY T006198) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: NY 007691-1) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-08-11 |