Healthcare Provider Details

I. General information

NPI: 1376661652
Provider Name (Legal Business Name): CFO RETAIL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 BROADWAY
NEW YORK NY
10003-4702
US

IV. Provider business mailing address

520 8TH AVE SUITE 901
NEW YORK NY
10018-6507
US

V. Phone/Fax

Practice location:
  • Phone: 212-475-0999
  • Fax: 212-420-0580
Mailing address:
  • Phone: 212-729-5373
  • Fax: 212-967-5927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. DARLEEN CETTINA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 212-729-5373