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General NPI Number Information
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NPI Number | 1265514541
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Entity Type | Organization
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Legal Business Name | J S G OPTOMETRY PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 918 HEMPSTEAD TPKE
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3637
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Country | US
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Telephone | 516-354-4242
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Fax | 516-354-4242
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Provider Business Mailing Address
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Address Line | 918 HEMPSTEAD TPKE
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3637
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Country | US
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Telephone | 516-354-4242
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Fax | 516-354-4242
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHERIN GEORGE
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Credential | O D
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Telephone | 516-354-4242
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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 | TUV006797
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License Number State | NY
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