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General NPI Number Information
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NPI Number | 1922242957
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Entity Type | Organization
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Legal Business Name | OPTICAL SHOPS OF AMERICA
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 23 MAIN ST
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-2916
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Country | US
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Telephone | 516-944-7161
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Fax | 516-944-7262
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Provider Business Mailing Address
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Address Line | 23 MAIN ST
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-2916
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Country | US
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Telephone | 516-944-7161
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Fax | 516-944-7262
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALAN SANDMAN
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Credential | OPHTHALMIC DISPENSER
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Telephone | 516-944-7161
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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 | 003218
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 003218
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License Number State | NY
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