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General NPI Number Information
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NPI Number | 1275751059
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Entity Type | Individual
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Provider Name | BRIAN JAY FRISCHER OPTICIAN
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1174A WANTAGH AVE
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City | WANTAGH
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State | NY
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Zip | 11793-2110
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Country | US
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Telephone | 516-221-2220
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Fax | 516-221-2228
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Provider Business Mailing Address
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Address Line | 2957 HAMPTON CT
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City | WANTAGH
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State | NY
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Zip | 11793-4607
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Country | US
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Telephone | 516-221-2038
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Fax | 516-221-2228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 006585-1
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License Number State | NY
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