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General NPI Number Information
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NPI Number | 1376762492
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Entity Type | Organization
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Legal Business Name | CENTRAL NASSAU OPTICAL, INC.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 2943 HEMPSTEAD TPKE
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City | LEVITTOWN
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State | NY
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Zip | 11756-1330
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Country | US
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Telephone | 516-731-5050
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Fax | 516-731-4900
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Provider Business Mailing Address
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Address Line | 2943 HEMPSTEAD TPKE
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City | LEVITTOWN
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State | NY
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Zip | 11756-1330
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Country | US
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Telephone | 516-731-5050
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Fax | 516-731-4900
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. JAY BRANDSTEIN
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Credential | OPHTHALMIC DISPENSER
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Telephone | 516-731-5050
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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 | 5342838
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License Number State | NY
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