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General NPI Number Information
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NPI Number | 1821211194
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Entity Type | Organization
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Legal Business Name | A.M.P. OPTICAL, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 4017 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11354-5518
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Country | US
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Telephone | 718-539-4313
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Fax | 718-539-4357
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Provider Business Mailing Address
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Address Line | 4017 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11354-5518
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Country | US
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Telephone | 718-539-4313
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Fax | 718-539-4357
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS PROTOPAPAS
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Credential | O.D.
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Telephone | 718-539-4313
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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 | T006601
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License Number State | NY
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