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General NPI Number Information
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NPI Number | 1922194802
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Entity Type | Organization
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Legal Business Name | POST PLAZA OPTICAL CORPORATION
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 12/31/2008
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Provider Practice Location Address
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Address Line | 862 JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-7505
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Country | US
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Telephone | 631-673-5010
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Fax | 631-673-5014
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Provider Business Mailing Address
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Address Line | 862 JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-7505
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Country | US
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Telephone | 631-673-5010
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Fax | 631-673-5014
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. MICHAEL JAMES PEPA
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Credential | OPT
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Telephone | 631-673-5010
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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 | 004573
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License Number State | NY
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