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General NPI Number Information
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NPI Number | 1699815258
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Entity Type | Organization
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Legal Business Name | FRUM OPTICIAN
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1205 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4612
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Country | US
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Telephone | 516-775-2606
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Fax | 516-775-2676
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Provider Business Mailing Address
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Address Line | 1205 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4612
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Country | US
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Telephone | 516-775-2606
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Fax | 516-775-2676
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. BARBARA RUBIN
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Credential | OPTICIAN
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Telephone | 516-775-2606
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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 | 6007
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License Number State | NY
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