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General NPI Number Information
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NPI Number | 1003988916
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Entity Type | Organization
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Legal Business Name | MATRIXX OPTICS LTD
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 216 FULTON AVE # A
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3705
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Country | US
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Telephone | 516-538-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 216 FULTON AVE # A
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3705
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Country | US
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Telephone | 516-538-3200
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MR. RUSSEL SPARER
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Credential |
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Telephone | 516-538-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV006759
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License Number State | NY
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