Healthcare Provider Details

I. General information

NPI: 1649418344
Provider Name (Legal Business Name): EYES & OPTICS LINCOLN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST ROOM 2-A3
BRONX NY
10451-5504
US

IV. Provider business mailing address

2922 AVENUE L
BROOKLYN NY
11210-4639
US

V. Phone/Fax

Practice location:
  • Phone: 718-665-0611
  • Fax: 718-665-3546
Mailing address:
  • Phone: 718-513-6911
  • Fax: 718-513-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberC-007816
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: AVRAHAM VIZEL
Title or Position: PRES
Credential:
Phone: 718-513-6911