| NPI | 1881773505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH RONALD GLASS Optometrist 516-775-7595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY VUT004288) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2011-05-25 |