Healthcare Provider Details
I. General information
NPI: 1962198325
Provider Name (Legal Business Name): SEE CLEARLY OPTICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2023
Last Update Date: 04/17/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 NAGLE AVENUE
NEW YORK NY
10040-1401
US
IV. Provider business mailing address
110 NAGLE AVENUE
NEW YORK NY
10040
US
V. Phone/Fax
- Phone: 929-638-0258
- Fax: 929-419-3687
- Phone: 929-638-0258
- Fax: 929-419-3687
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 156F00000X |
| Taxonomy | Technician/Technologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAURIE
D
VU
Title or Position: CEO
Credential: OD
Phone: 929-638-0258