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NPI 1962508994

NPI 1962508994 : 23RD STREET OPTICAL : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1962508994
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    Entity Type          |    Organization 
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    Legal Business Name  |    23RD STREET OPTICAL 
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Dates
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    Enumeration Date     |    09/16/2006
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    106 E 23RD ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10010-4516
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    Country              |    US
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    Telephone            |    212-677-3707
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    Fax                  |    212-477-9415
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Provider Business Mailing Address
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    Address Line         |    106 E 23RD ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10010-4516
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    Country              |    US
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    Telephone            |    212-677-3707
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    Fax                  |    212-477-9415
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MRS. ELYSE GAIL ROTHSCHILD 
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    Credential           |    
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    Telephone            |    212-677-3707
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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       |    
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    License Number State |    NY
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