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General NPI Number Information
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NPI Number | 1124213137
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Entity Type | Organization
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Legal Business Name | RIVKA OPTICIANS
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 114 E 27TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-8969
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Country | US
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Telephone | 212-473-4014
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Fax | 212-685-9136
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Provider Business Mailing Address
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Address Line | 114 E 27TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-8969
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Country | US
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Telephone | 212-473-4014
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Fax | 212-685-9136
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Authorized Official
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Title or Position | OWNER
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Name | MR. NATHAN BOROCHOV
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Credential | LICENSED OPTICIAN
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Telephone | 212-473-4014
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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 | 3413
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License Number State | NY
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