| NPI | 1497905087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JODY KOGAN Owner 718-465-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007418-1) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2015-03-18 |