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General NPI Number Information
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NPI Number | 1790076933
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Entity Type | Organization
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Legal Business Name | CHEAPER PEEPERS OF NEW YORK MDIV, INC
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 1441 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4614
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Country | US
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Telephone | 516-502-4552
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Fax | 516-502-4554
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Provider Business Mailing Address
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Address Line | 1441 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4614
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Country | US
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Telephone | 516-502-4552
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Fax | 516-502-4554
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH DOHERTY
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Credential |
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Telephone | 51685252473
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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 | 2583
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License Number State | NY
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