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General NPI Number Information
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NPI Number | 1831433002
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Entity Type | Organization
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Legal Business Name | NEW PRISMS OPTICAL, LLC
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 11/12/2012
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Provider Practice Location Address
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Address Line | 2575 LINDELL RD
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City | LAS VEGAS
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State | NV
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Zip | 89146-5409
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Country | US
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Telephone | 702-365-6474
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Fax | 702-365-6828
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Provider Business Mailing Address
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Address Line | 2575 LINDELL RD
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City | LAS VEGAS
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State | NV
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Zip | 89146-5409
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Country | US
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Telephone | 702-365-6474
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Fax | 702-365-6828
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Authorized Official
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Title or Position | OWNER
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Name | DOMINIC CERMINARA
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Credential |
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Telephone | 702-365-6474
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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 |
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License Number State |
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