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General NPI Number Information
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NPI Number | 1679933642
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Entity Type | Organization
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Legal Business Name | CENTRAL BROOKLYN VISION SERVICES
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 529 NOSTRAND AVE SUITE 1
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City | BROOKLYN
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State | NY
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Zip | 11216-2879
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Country | US
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Telephone | 718-638-1844
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Fax | 866-910-7380
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Provider Business Mailing Address
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Address Line | 529 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11216-2879
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Country | US
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Telephone | 718-638-1844
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Fax | 866-910-7380
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Authorized Official
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Title or Position | CEO
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Name | DR. LAMONT PIERRE FREEMAN
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Credential | O.D
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Telephone | 917-495-0357
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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 | TUV003831-1
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License Number State | NY
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