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NPI Code Detail

MEDICARE: COHEN FASHION OPTICAL, LLC

MEDICARE: COHEN FASHION OPTICAL, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear Supplier002022PA

General Provider Information

NPI Number : 1376022491
Entity Type Code : Organization
Provider Name (Legal Business Name) : COHEN FASHION OPTICAL, LLC
Provider Business Mailing Address
First Line : 100 QUENTIN ROOSEVELT BLVD STE 400
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-4843
Country : US
Telephone Number : 516-465-6905
Fax Number : 516-465-6980
Provider Business Practice Location Address
First Line : 1547 W PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-3029
Country : US
Telephone Number : 215-334-3652
Fax Number : 215-334-8785
Authorized Official
Title or Position : MGR
Name : MARY OSHEA
Credential :
Telephone Number : 646-413-4186
Provider Enumeration Date : 08/09/2018
Last Update Date : 08/09/2018

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Directions to “COHEN FASHION OPTICAL, LLC ” Practice Location

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