=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154505436
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SEE BETTER,INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2007
-----------------------------------------------------
Last Update Date | 12/22/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1450 BROADWAY
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10018-2201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-719-1391
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1450 BROADWAY
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10018-2201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-719-1391
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. STANISLAV V ILYUSHA
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 212-719-1391
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | TUV006443
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------