| NPI | 1942285721 |
|---|---|
| Doing Business As | WAVECREST OPTICAL SHOP |
| Entity Type | Organization |
| Authorized Contact | BARRY SCOTT RAINES Optician/Owner 718-327-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NY 005665) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2007-07-20 |