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General NPI Number Information
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NPI Number | 1508129651
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Entity Type | Organization
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Legal Business Name | VILLAGE OPTICAL, CORP
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 5 GREENWICH AVE
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City | NEW YORK
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State | NY
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Zip | 10014-3543
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Country | US
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Telephone | 212-645-1395
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Fax | 212-645-2710
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Provider Business Mailing Address
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Address Line | 5 GREENWICH AVE
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City | NEW YORK
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State | NY
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Zip | 10014-3543
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Country | US
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Telephone | 212-645-1395
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Fax | 212-645-2710
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Authorized Official
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Title or Position | MGR
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Name | ALEX GRINSHPUN
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Credential |
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Telephone | 212-645-1395
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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 | 003908-1
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License Number State | NY
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