| NPI | 1205234267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CARUSO Director Of Credentialing 646-660-1993 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2024-02-15 |