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General NPI Number Information
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NPI Number | 1588101836
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Entity Type | Organization
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Legal Business Name | B & E EYEWEAR INC
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 59 MERRICK RD STE B
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City | AMITYVILLE
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State | NY
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Zip | 11701-3453
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Country | US
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Telephone | 631-485-3636
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Fax | 516-493-9322
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Provider Business Mailing Address
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Address Line | 59 MERRICK RD STE B
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City | AMITYVILLE
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State | NY
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Zip | 11701-3453
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Country | US
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Telephone | 631-485-3636
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Fax | 516-493-9322
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BORIS TAKHALOV
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Credential |
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Telephone | 347-418-2730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 009414-1
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License Number State | NY
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