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General NPI Number Information
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NPI Number | 1720746076
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Entity Type | Organization
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Legal Business Name | NAMDAR OPTOMETRY PC
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 308 BEACH 9TH ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-5589
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Country | US
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Telephone | 718-327-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 308 BEACH 9TH ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-5589
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Country | US
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Telephone | 718-327-0048
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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. BRACHA NAMDAR
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Credential |
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Telephone | 718-327-0048
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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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