| NPI | 1396527222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN FUZAYLOV Owner 917-412-3750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |