Healthcare Provider Details

I. General information

NPI: 1194037812
Provider Name (Legal Business Name): EYES & OPTICS GOUV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2010
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 MADISON ST
NEW YORK NY
10002-7537
US

IV. Provider business mailing address

2922 AVENUE L
BROOKLYN NY
11210-4639
US

V. Phone/Fax

Practice location:
  • Phone: 212-346-2020
  • Fax:
Mailing address:
  • Phone: 718-513-6911
  • Fax: 718-513-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License NumberC007816
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