| NPI | 1598932709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT L. DERCO Secretary 631-666-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY VUT-4532-1) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |