Healthcare Provider Details

I. General information

NPI: 1144391749
Provider Name (Legal Business Name): BRISTOL OPTICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 PENNSYLVANIA AVE
BROOKLYN NY
11207-8416
US

IV. Provider business mailing address

949 PENNSYLVANIA AVE
BROOKLYN NY
11207-8416
US

V. Phone/Fax

Practice location:
  • Phone: 718-649-6526
  • Fax: 718-272-3722
Mailing address:
  • Phone: 718-649-6526
  • Fax: 718-272-3722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number4854
License Number StateNY

VIII. Authorized Official

Name: MR. STEVEN SMALL
Title or Position: PRESIDENT
Credential:
Phone: 718-649-6526