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General NPI Number Information
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NPI Number | 1104146232
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Entity Type | Organization
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Legal Business Name | VERRAZANO VISION INC
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 8421 3RD AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-4601
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Country | US
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Telephone | 718-491-2300
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Fax | 718-491-2298
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Provider Business Mailing Address
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Address Line | 8421 3RD AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-4601
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Country | US
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Telephone | 718-491-2300
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Fax | 718-491-2298
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. ROSEANNE MARGARET RICCIARDI
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Credential | O.D.
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Telephone | 718-491-2300
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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 | TUV004325
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License Number State | NY
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