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General NPI Number Information
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NPI Number | 1003973223
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Entity Type | Organization
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Legal Business Name | CRESTON OPTICIANS INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 2169 WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10462-1405
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Country | US
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Telephone | 718-409-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 2169 WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10462-1405
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Country | US
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Telephone | 718-409-2200
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | MR. DOUGLAS T BERGER
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Credential | OPTICIAN
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Telephone | 718-409-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | VUT002933-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | VUT002933-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | VUT002933-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | VUT002933-1
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number | 005104-1
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number | 005104-1
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 005104-1
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT002933-1
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License Number State | NY
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