| NPI | 1518669571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHEAK TANG Owner/Opticians 203-494-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-04-26 |