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General NPI Number Information
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NPI Number | 1326235227
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Entity Type | Organization
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Legal Business Name | COLLEGE POINT OPTOMETRIC ASSOCIATES P.C.
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 1826 COLLEGE POINT BLVD
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City | COLLEGE POINT
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State | NY
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Zip | 11356-2221
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Country | US
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Telephone | 718-359-2834
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Fax |
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Provider Business Mailing Address
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Address Line | 1826 COLLEGE POINT BLVD
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City | COLLEGE POINT
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State | NY
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Zip | 11356-2221
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Country | US
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Telephone | 718-359-2834
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ANASTASIOS FOKAS
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Credential | O.D.
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Telephone | 718-359-2834
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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 | TUV3614
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License Number State | NY
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