| NPI | 1821186651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRAZELL BENJAMIN Owner 718-994-2753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: NY tuv005815-1) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NY 0024881) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2009-10-20 |