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General NPI Number Information
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NPI Number | 1477598555
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Entity Type | Organization
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Legal Business Name | ROCKLEDGE OPTICAL
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 160 S CENTRAL AVE
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City | ELMSFORD
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State | NY
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Zip | 10523-3509
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Country | US
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Telephone | 914-347-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 160 S CENTRAL AVE
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City | ELMSFORD
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State | NY
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Zip | 10523-3509
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Country | US
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Telephone | 914-347-2266
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Fax |
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Authorized Official
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Title or Position | OPTICAN
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Name | JOHN GIAMBALVO
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Credential |
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Telephone | 914-347-2266
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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 |
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License Number State |
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