| NPI | 1831275510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR VALERY SUPITSKIY President 718-773-9391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV0056301) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NY 007691-1) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |