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General NPI Number Information
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NPI Number | 1497935217
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Entity Type | Organization
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Legal Business Name | B&VOPTICAL
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 98 SAINT JOHNS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3026
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Country | US
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Telephone | 888-449-6899
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Fax | 718-981-5247
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Provider Business Mailing Address
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Address Line | 98 SAINT JOHNS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3026
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Country | US
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Telephone | 888-449-6899
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Fax | 718-981-5247
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BORIS ROZHANSKY
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Credential |
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Telephone | 917-306-5191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 6307
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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