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General NPI Number Information
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NPI Number | 1699130617
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Entity Type | Organization
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Legal Business Name | EYE TSE OPTICAL, INC
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 3709 MAIN ST 1ST FLOOR
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City | FLUSHING
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State | NY
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Zip | 11354-6518
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Country | US
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Telephone | 718-621-6305
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Fax | 718-621-6307
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Provider Business Mailing Address
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Address Line | 3709 MAIN ST 1ST FLOOR
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City | FLUSHING
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State | NY
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Zip | 11354-6518
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Country | US
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Telephone | 718-621-6305
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Fax | 718-621-6307
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. WILLIAM LING
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Credential | O.D.
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Telephone | 917-968-1954
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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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