Healthcare Provider Details

I. General information

NPI: 1760126882
Provider Name (Legal Business Name): OPR EYEWEAR INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/25/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 NINTH AVE
NEW YORK NY
10001
US

IV. Provider business mailing address

435 W 31ST ST
NEW YORK NY
10001-4658
US

V. Phone/Fax

Practice location:
  • Phone: 917-826-7475
  • Fax:
Mailing address:
  • Phone: 917-826-7475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. IDRISS NESTOR
Title or Position: OWNER
Credential:
Phone: 917-826-7475