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General NPI Number Information
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NPI Number | 1417321985
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Entity Type | Organization
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Legal Business Name | SW OPTIKS CORP.
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Dates
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Enumeration Date | 11/21/2015
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Last Update Date | 11/21/2015
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Provider Practice Location Address
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Address Line | 184 GLEN COVE AVE
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City | GLEN COVE
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State | NY
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Zip | 11542-4395
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Country | US
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Telephone | 516-656-2020
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Fax | 516-674-2021
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Provider Business Mailing Address
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Address Line | 184 GLEN COVE AVE
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City | GLEN COVE
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State | NY
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Zip | 11542-4395
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Country | US
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Telephone | 516-656-2020
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Fax | 516-674-2021
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MR. WILLIAM FERNANDEZ
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Credential | OPHTHALMIC DISPENCER
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Telephone | 516-459-3177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 009319-1
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License Number State | NY
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