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General NPI Number Information
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NPI Number | 1437317591
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Entity Type | Organization
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Legal Business Name | LARKFIELD OPTICAL INC.
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 517 LARKFIELD RD
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4208
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Country | US
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Telephone | 631-368-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 517 LARKFIELD RD
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4208
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Country | US
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Telephone | 631-368-2020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JAY BRANDSTEIN
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Credential |
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Telephone | 631-368-2020
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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 | 6371309
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License Number State | NY
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