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General NPI Number Information
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NPI Number | 1306088877
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Entity Type | Organization
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Legal Business Name | UNIVERSAL OPTICAL
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 1397 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-3503
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Country | US
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Telephone | 718-462-0221
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Fax |
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Provider Business Mailing Address
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Address Line | 31 MILBURN DR
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-2256
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Country | US
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Telephone | 908-431-5118
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. DONALD D. GUERRIER
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Credential | O.D
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Telephone | 718-462-0221
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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 | VUT005719
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License Number State | NY
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