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General NPI Number Information
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NPI Number | 1104949072
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Entity Type | Organization
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Legal Business Name | CN VISION CARE INC
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4555 46TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-5227
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Country | US
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Telephone | 718-392-1244
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Fax |
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Provider Business Mailing Address
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Address Line | 4555 46TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-5227
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Country | US
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Telephone | 718-392-1244
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NICOLAS LOPE
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Credential | OPHTHALMIC DISPENSER
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Telephone | 718-392-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 005711
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License Number State | NY
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