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General NPI Number Information
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NPI Number | 1831231729
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Entity Type | Organization
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Legal Business Name | CENTRAL OPTOMETRY PC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 1110 PENNSYLVANIA AVE
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City | BROOKLYN
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State | NY
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Zip | 11207-9061
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Country | US
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Telephone | 718-257-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 PENNSYLVANIA AVE
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City | BROOKLYN
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State | NY
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Zip | 11207-9061
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Country | US
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Telephone | 718-257-7700
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATERINA GINBERG
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Credential | DO
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Telephone | 718-257-7700
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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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