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General NPI Number Information
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NPI Number | 1336373745
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Entity Type | Organization
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Legal Business Name | E AND D OPTICAL INC.
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 5822 99TH ST
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City | CORONA
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State | NY
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Zip | 11368-4306
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Country | US
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Telephone | 718-760-7776
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Fax |
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Provider Business Mailing Address
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Address Line | 5822 99TH ST
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City | CORONA
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State | NY
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Zip | 11368-4306
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Country | US
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Telephone | 718-760-7776
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DAVID ABRAMOV
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Credential |
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Telephone | 718-760-7776
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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 | TUV005712-1
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License Number State | NY
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