Healthcare Provider Details

I. General information

NPI: 1962048116
Provider Name (Legal Business Name): COHEN FASHION OPTICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BACKUS AVE
DANBURY CT
06810-7422
US

IV. Provider business mailing address

7 BACKUS AVE
DANBURY CT
06810-7422
US

V. Phone/Fax

Practice location:
  • Phone: 203-790-1341
  • Fax: 203-790-5052
Mailing address:
  • Phone: 203-790-1341
  • Fax: 203-790-5052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MARY OSHEA
Title or Position: MANAGER
Credential:
Phone: 646-413-4186