| NPI | 1992746358 |
|---|---|
| Former Legal Business Name | EYESUPPLY OF WANTAGH |
| Entity Type | Organization |
| Authorized Contact | BRIAN FRISCHER Optician 516-221-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY VUT004589-1) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY VUT005770) |
| 152W00000X Optometrist (Licence: NY T005875-1) | |
| 156FX1800X Technician/Technologist, Optician (Licence: NY 6585) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2008-06-12 |