| NPI | 1336514819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SKYE SEYFFARTH Credentialing Manager 631-294-2329 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2026-03-20 |