Healthcare Provider Details

I. General information

NPI: 1659499648
Provider Name (Legal Business Name): COHEN'S FASHION OPTICAL OF PUERTO RICO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA LAS AMERICAS #186
HATO REY PR
00918
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 787-777-0990
  • Fax: 787-274-0747
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: DARLEEN CETTINA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 212-729-5373