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General NPI Number Information
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NPI Number | 1588865018
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Entity Type | Organization
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Legal Business Name | 3 EYED OPTICAL
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 3 EYED OPTICAL DBA MANHATTAN EYEWORKS 100 EAST 96 STREET, GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-722-9233
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Fax | 212-722-9208
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Provider Business Mailing Address
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Address Line | 3 EYED OPTICAL DBA MANHATTAN EYEWORKS 100 EAST 96 STREET, GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-722-9233
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Fax | 212-722-9208
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID FORREST GROSS
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Credential | O.D.
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Telephone | 212-722-9233
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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 | NY4780
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License Number State | NY
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