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General NPI Number Information
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NPI Number | 1962710376
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Entity Type | Organization
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Legal Business Name | DES OPTOMETRY, PLLC
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 40 ATLANTIC AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-2037
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Country | US
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Telephone | 516-255-2020
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Fax | 516-255-1818
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Provider Business Mailing Address
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Address Line | 40 ATLANTIC AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-2037
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Country | US
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Telephone | 516-255-2020
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Fax | 516-255-1818
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DAVID YU
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Credential | OD
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Telephone | 516-255-2020
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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 | TUV006549
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License Number State | NY
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