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General NPI Number Information
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NPI Number | 1811703085
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Entity Type | Organization
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Legal Business Name | EYE WORLD OPTICAL BTC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 3431 48TH ST
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-1001
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Country | US
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Telephone | 917-721-7324
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Fax |
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Provider Business Mailing Address
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Address Line | 7050 KESSEL ST
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City | FOREST HILLS
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State | NY
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Zip | 11375-5844
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Country | US
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Telephone | 917-721-7324
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SAL MATATOV
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Credential |
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Telephone | 917-721-7324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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