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General NPI Number Information
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NPI Number | 1538491188
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Entity Type | Organization
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Legal Business Name | OPTICAL CONCEPTS OF ROCKLAND INC
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 164 E ROUTE 59
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City | NANUET
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State | NY
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Zip | 10954-2910
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Country | US
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Telephone | 845-623-8074
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Fax | 845-623-4028
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Provider Business Mailing Address
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Address Line | 164 E ROUTE 59
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City | NANUET
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State | NY
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Zip | 10954-2910
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Country | US
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Telephone | 845-623-8074
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Fax | 845-623-4028
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JACK LEOPOLD
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Credential |
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Telephone | 845-623-8074
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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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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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