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NPI Code Detail

MEDICARE: EXPLORER OPTICAL INC

MEDICARE: EXPLORER OPTICAL INC
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
1261QM2500XMedical Specialty Clinic/Center

General Provider Information

NPI Number : 1538623376
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXPLORER OPTICAL INC
Provider Business Mailing Address
First Line : 1351 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-2049
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1351 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-2049
Country : US
Telephone Number : 718-564-5484
Fax Number :
Authorized Official
Title or Position : CEO
Name : ALEKSANDR RITS
Credential :
Telephone Number : 718-564-5484
Provider Enumeration Date : 01/25/2019
Last Update Date : 07/24/2019

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Directions to “EXPLORER OPTICAL INC ” Practice Location

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