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General NPI Number Information
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NPI Number | 1639896335
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Entity Type | Organization
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Legal Business Name | NYC 1312 LLC
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 1312 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11229-3306
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Country | US
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Telephone | 718-304-0533
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Fax | 718-304-0535
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Provider Business Mailing Address
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Address Line | 1312 AVENUE U
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City | BROOKLYN
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State | NY
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Zip | 11229-3306
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Country | US
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Telephone | 718-304-0533
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Fax | 718-304-0535
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Authorized Official
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Title or Position | MANAGER
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Name | CHI JIN CHOCK
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Credential |
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Telephone | 646-373-8812
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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