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General NPI Number Information
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NPI Number | 1932387461
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Entity Type | Organization
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Legal Business Name | JUST YOU AND EYE OPT INC
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 1303 MAIN ST SUITE E
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2257
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Country | US
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Telephone | 631-331-5546
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 MAIN ST SUITE E
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2257
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Country | US
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Telephone | 631-331-5546
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAYMOND CARL PORZIO
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Credential | OPTICIAN
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Telephone | 631-331-5546
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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 | 4330
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License Number State | NY
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