Healthcare Provider Details

I. General information

NPI: 1881500494
Provider Name (Legal Business Name): IEA ASTORIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2248 31ST ST
ASTORIA NY
11105-2714
US

IV. Provider business mailing address

2248 31ST ST
ASTORIA NY
11105-2714
US

V. Phone/Fax

Practice location:
  • Phone: 718-267-1333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON OR
Title or Position: OPTOMETRIST
Credential: OD
Phone: 917-817-1868