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General NPI Number Information
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NPI Number | 1922373000
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Entity Type | Organization
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Legal Business Name | SUPER OPTICAL INC.
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 1549 WESTCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10472-2910
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Country | US
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Telephone | 917-792-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1549 WESTCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10472-2910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEHMET CALIK
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Credential |
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Telephone | 917-792-3500
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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 | TUV005575
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License Number State | NY
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