Healthcare Provider Details
I. General information
NPI: 1740823863
Provider Name (Legal Business Name): OCULAR HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2019
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
512 W 29TH ST
NEW YORK NY
10001-1308
US
IV. Provider business mailing address
400 5TH AVE APT 37F
NEW YORK NY
10018-5946
US
V. Phone/Fax
- Phone: 703-395-4411
- Fax:
- Phone: 703-395-4411
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JENNIFER
TSAI
Title or Position: MEMBER
Credential: OD
Phone: 703-395-4411