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General NPI Number Information
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NPI Number | 1619290772
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Entity Type | Organization
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Legal Business Name | JMB OPTICAL MONSEY INC
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 86 ROUTE 59
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City | AIRMONT
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State | NY
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Zip | 10952-3741
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Country | US
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Telephone | 845-738-1464
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Fax |
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Provider Business Mailing Address
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Address Line | 86 ROUTE 59
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City | AIRMONT
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State | NY
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Zip | 10952-3741
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Country | US
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Telephone | 845-738-1464
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ABRAHAM MAYER
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Credential |
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Telephone | 718-637-6512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 008762-1
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License Number State | NY
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