| NPI | 1255138657 |
|---|---|
| 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 | 2025-02-25 |
| Last Update Date | 2025-04-01 |