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General NPI Number Information
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NPI Number | 1285092551
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Entity Type | Organization
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Legal Business Name | CLEAR SIGHT OPTICAL CORP.
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 2791 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5882
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Country | US
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Telephone | 718-494-9257
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Fax | 718-494-4183
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Provider Business Mailing Address
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Address Line | 2791 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5882
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Country | US
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Telephone | 718-494-9257
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Fax | 718-494-4183
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LAURA ZAVILENSKY
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Credential |
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Telephone | 718-477-6700
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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 |
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License Number State |
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