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General NPI Number Information
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NPI Number | 1245454917
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Entity Type | Organization
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Legal Business Name | LENS LAB EXPRESS, INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16334 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4912
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Country | US
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Telephone | 718-526-2332
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Fax | 718-297-3349
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Provider Business Mailing Address
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Address Line | 16334 JAMAICA AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4912
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Country | US
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Telephone | 718-526-2332
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Fax | 718-297-3349
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALAN SICHERMAN
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Credential |
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Telephone | 718-526-2332
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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 | 002552-1
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License Number State | NY
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