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General NPI Number Information
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NPI Number | 1346628278
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Entity Type | Organization
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Legal Business Name | COHEN FASHION OPTICAL LLC
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 100 QUENTIN ROOSEVELT BLVD SUITE 400
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City | GARDEN CITY
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State | NY
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Zip | 11530-4874
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Country | US
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Telephone | 212-792-8149
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Fax | 646-448-3327
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Provider Business Mailing Address
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Address Line | 520 8TH AVE SUITE 900
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City | NEW YORK
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State | NY
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Zip | 10018-6507
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Country | US
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Telephone | 212-792-8149
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Fax | 646-448-3327
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | LAURA VALENTIN
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Credential |
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Telephone | 212-792-8149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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