| NPI | 1518359223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEI WADE Credentialing Specialist 212-792-8167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-04 |