Healthcare Provider Details

I. General information

NPI: 1659694875
Provider Name (Legal Business Name): COURAGEOUS OPTOMETRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 10/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 LEE BLVD STERLING OPTICAL
YORKTOWN HEIGHTS NY
10598-1100
US

IV. Provider business mailing address

650 LEE BLVD STERLING OPTICAL
YORKTOWN HEIGHTS NY
10598-1100
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-8111
  • Fax:
Mailing address:
  • Phone: 914-245-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW JAY FREILICH
Title or Position: PRESIDENT
Credential: OD
Phone: 914-245-8111