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General NPI Number Information
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NPI Number | 1568648574
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Entity Type | Organization
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Legal Business Name | OPTI-KING,LLC.
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Dates
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Enumeration Date | 01/21/2008
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Last Update Date | 01/21/2008
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Provider Practice Location Address
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Address Line | 101 SHERMAN AVE #8
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City | NEW YORK
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State | NY
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Zip | 10034-5626
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Country | US
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Telephone | 212-569-2020
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Fax | 212-569-2021
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Provider Business Mailing Address
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Address Line | 101 SHERMAN AVE #8
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City | NEW YORK
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State | NY
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Zip | 10034-5626
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Country | US
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Telephone | 212-569-2020
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Fax | 212-569-2021
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Authorized Official
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Title or Position | MEMBER
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Name | XIMENA BERNSTEIN
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Credential |
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Telephone | 201-926-1912
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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 | TUV006758
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License Number State | NY
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