| NPI | 1811066111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VADIM KRUZHKOV Manager 718-388-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY t6451-1) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NY 007005) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |