| NPI | 1528467610 |
|---|---|
| Doing Business As | PAVONIA OPTICAL |
| Entity Type | Organization |
| Authorized Contact | WILLIAN CONSTAD Member 201-436-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2016-11-17 |