| NPI | 1407185283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD BANGIYEV Owner/Optician 347-475-6692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 008630) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2009-12-08 |