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General NPI Number Information
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NPI Number | 1871852541
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Entity Type | Organization
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Legal Business Name | MINZER'S OPTICAL INC.
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 907 48TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-2919
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Country | US
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Telephone | 718-436-6963
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Fax | 718-431-8786
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Provider Business Mailing Address
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Address Line | 907 48TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-2919
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Country | US
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Telephone | 718-436-6963
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Fax | 718-431-8786
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MORDECHAI B. MINZER
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Credential | OPHTHALMIC DISPENSER
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Telephone | 718-436-6963
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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 | 005522-1
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License Number State | NY
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