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General NPI Number Information
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NPI Number | 1720288814
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Entity Type | Organization
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Legal Business Name | R.J.R. OPTICAL INC.
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 160 WALT WHITMAN RD STE 1077
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4129
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Country | US
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Telephone | 631-271-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 160 WALT WHITMAN RD STE 1077
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4129
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Country | US
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Telephone | 631-271-9898
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT DAVIDOWITZ
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Credential | O.D.
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Telephone | 631-271-9898
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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 | 4393
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License Number State | NY
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