| NPI | 1619456589 |
|---|---|
| Doing Business As | FABULOUS OPTICAL |
| Entity Type | Organization |
| Authorized Contact | EDWARD BANGIYEV Owner 212-665-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2021-07-07 |