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General NPI Number Information
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NPI Number | 1487432522
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Entity Type | Organization
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Legal Business Name | OPTICS DIAGNOSTICS LLC
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 519 GATEWAY DR
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City | BROOKLYN
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State | NY
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Zip | 11239-2801
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Country | US
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Telephone | 347-569-8702
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Fax |
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Provider Business Mailing Address
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Address Line | 524 OCEAN VIEW AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-6831
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Country | US
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Telephone | 845-219-8018
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ABUZER HASAN
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Credential | OD
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Telephone | 845-219-8018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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