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General NPI Number Information
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NPI Number | 1679436778
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Entity Type | Organization
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Legal Business Name | MY LENS DR GROUP INC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3009 CHURCH AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-4209
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Country | US
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Telephone | 718-814-2020
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Fax | 347-315-1450
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Provider Business Mailing Address
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Address Line | 455 LENOX AVE
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City | NEW YORK
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State | NY
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Zip | 10037-0982
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Country | US
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Telephone | 212-368-2020
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Fax | 212-368-2029
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEX VAYSBAUM
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Credential |
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Telephone | 718-814-2020
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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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