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General NPI Number Information
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NPI Number | 1699963769
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Entity Type | Organization
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Legal Business Name | KIPS BAY OPTICAL LTD
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Dates
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Enumeration Date | 10/13/2007
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 608 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10016-4859
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Country | US
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Telephone | 212-686-1653
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Fax | 212-686-1654
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Provider Business Mailing Address
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Address Line | 608 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10016-4859
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Country | US
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Telephone | 212-686-1653
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Fax | 212-686-1654
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL TALONE
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Credential | OD
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Telephone | 814-234-2015
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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 | TUV003290-1
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License Number State | NY
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