=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578787677
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CFO RETAIL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2007
-----------------------------------------------------
Last Update Date | 09/02/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 805 3RD AVENUE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10022-7513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-750-9005
-----------------------------------------------------
Fax | 212-421-7708
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 520 EIGHTH AVENUE SUITE 901
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-729-5373
-----------------------------------------------------
Fax | 212-967-5927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | MRS. DARLEEN CETTINA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 212-729-5373
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------