Healthcare Provider Details

I. General information

NPI: 1023769379
Provider Name (Legal Business Name): KLARITY OPTICAL 2020 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 FLATBUSH AVE
BROOKLYN NY
11226-6118
US

IV. Provider business mailing address

1083 FLATBUSH AVE
BROOKLYN NY
11226-6118
US

V. Phone/Fax

Practice location:
  • Phone: 718-282-6700
  • Fax:
Mailing address:
  • Phone: 718-282-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: JAMES BISSRAITHE
Title or Position: OWNER
Credential:
Phone: 718-282-6700