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General NPI Number Information
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NPI Number | 1366541146
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Entity Type | Organization
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Legal Business Name | RIDGEWOOD OPTICAL, INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5902 CATALPA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4461
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Country | US
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Telephone | 718-821-1112
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Fax |
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Provider Business Mailing Address
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Address Line | 5902 CATALPA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4461
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Country | US
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Telephone | 718-821-1112
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | ANGELA MARIA ONCIU-FLOREA
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Credential | OPTICIAN
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Telephone | 718-821-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 006870
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License Number State | NY
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