| NPI | 1619306123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR KOLESNYK Manager 718-915-0791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation |
| 156FC0800X Technician/Technologist, Contact Lens | |
| 156FX1800X Technician/Technologist, Optician | |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |