| NPI | 1508194689 |
|---|---|
| Doing Business As | FABULOUS OPTICAL |
| Entity Type | Organization |
| Authorized Contact | MARK BANGIYEV Owner 718-658-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007405) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |