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General NPI Number Information
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NPI Number | 1891035069
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Entity Type | Organization
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Legal Business Name | OPTICS BY MDB INC
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Dates
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Enumeration Date | 02/25/2013
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 14 PURCHASE ST
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City | RYE
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State | NY
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Zip | 10580-3003
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Country | US
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Telephone | 914-967-5565
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Fax | 914-967-5814
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Provider Business Mailing Address
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Address Line | 14 PURCHASE ST
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City | RYE
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State | NY
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Zip | 10580-3003
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Country | US
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Telephone | 914-967-5565
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Fax | 914-967-5814
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Authorized Official
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Title or Position | DOCTOR
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Name | GAYLE POLLAK HARRIS
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Credential | OPTOMETREIST
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Telephone | 914-967-5565
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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 | TUV005933-1
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License Number State | NY
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