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General NPI Number Information
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NPI Number | 1689057580
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Entity Type | Organization
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Legal Business Name | PLESSEN OPTICAL, LLC
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 6 ORANGE GROVE
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City | CHRISTIANSTED
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State | VI
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Zip | 00820
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Country | US
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Telephone | 340-715-7720
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Fax | 340-713-9002
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Provider Business Mailing Address
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Address Line | 3004 ORANGE GROVE SUITE 2
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-4288
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Country | US
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Telephone | 340-715-7720
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Fax | 340-713-9002
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Authorized Official
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Title or Position | CEO
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Name | DR. JAN BIJAN TAWAKOL
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Credential | M.D.
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Telephone | 340-715-7720
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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 |
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License Number State |
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