Healthcare Provider Details

I. General information

NPI: 1316273980
Provider Name (Legal Business Name): CFO RETAIL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 QUENTIN ROOSEVELT BLVD SUITE 400
GARDEN CITY NY
11530-4874
US

IV. Provider business mailing address

100 QUENTIN ROOSEVELT BLVD SUITE 400
GARDEN CITY NY
11530-4874
US

V. Phone/Fax

Practice location:
  • Phone: 212-729-5300
  • Fax:
Mailing address:
  • Phone: 212-729-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN COHEN
Title or Position: PRESIDENT
Credential: OD
Phone: 212-729-5300