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General NPI Number Information
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NPI Number | 1639590128
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Entity Type | Organization
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Legal Business Name | SEZANI & CO. OPTICIAL
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Dates
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Enumeration Date | 12/30/2013
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 1006 6TH AVE
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City | NEW YORK
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State | NY
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Zip | 10018-0169
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Country | US
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Telephone | 212-764-6133
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Fax | 212-764-6136
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Provider Business Mailing Address
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Address Line | 1006 6TH AVE
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City | NEW YORK
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State | NY
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Zip | 10018-0169
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Country | US
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Telephone | 212-764-6133
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Fax | 212-764-6136
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Authorized Official
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Title or Position | OPTICIAN/MANAGER
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Name | MRS. BETTY KIMYAGAROVA
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Credential |
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Telephone | 212-764-6133
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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 | 00053991
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License Number State | NY
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