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General NPI Number Information
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NPI Number | 1932237823
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Entity Type | Organization
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Legal Business Name | ADVANTAGE OPTIX, INC.
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 1445 HEMPSTEAD TPKE PEARLE VISION
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City | ELMONT
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State | NY
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Zip | 11003-2404
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Country | US
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Telephone | 516-616-1771
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Fax | 516-616-0473
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Provider Business Mailing Address
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Address Line | 1445 HEMPSTEAD TPKE PEARLE VISION
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City | ELMONT
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State | NY
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Zip | 11003-2404
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Country | US
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Telephone | 516-616-1771
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Fax | 516-616-0473
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ALLA SLOOTSKY
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Credential |
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Telephone | 516-616-1771
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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 | 007987
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License Number State | NY
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