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General NPI Number Information
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NPI Number | 1760803084
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Entity Type | Organization
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Legal Business Name | THIRD EYE CHIC OPTOMETRY PLLC
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Dates
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Enumeration Date | 01/06/2014
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Last Update Date | 01/06/2014
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Provider Practice Location Address
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Address Line | 220 MURRAY ST
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City | NEW YORK
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State | NY
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Zip | 10282-5600
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Country | US
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Telephone | 212-227-2400
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Fax | 212-227-2624
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Provider Business Mailing Address
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Address Line | 220 MURRAY ST
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City | NEW YORK
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State | NY
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Zip | 10282-5600
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Country | US
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Telephone | 212-227-2400
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Fax | 212-227-2624
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Authorized Official
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Title or Position | OWNER
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Name | VERONICA RUELAS
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Credential | O.D.
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Telephone | 212-227-2400
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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 | TUV005969-1
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License Number State | NY
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