| NPI | 1366584559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEJUAN LAMONT WYNN Owner 212-222-6048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NY 164759) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2010-02-23 |