Healthcare Provider Details

I. General information

NPI: 1013796754
Provider Name (Legal Business Name): PRIME OPTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2023
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 VERNON BLVD
ASTORIA NY
11106-4927
US

IV. Provider business mailing address

8626 122ND ST
RICHMOND HILL NY
11418-2505
US

V. Phone/Fax

Practice location:
  • Phone: 718-267-3687
  • Fax: 718-267-3692
Mailing address:
  • Phone: 718-267-3687
  • Fax: 718-267-3692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BHAJNEET KAUR
Title or Position: OWNER
Credential: OD
Phone: 718-267-3687