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General NPI Number Information
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NPI Number | 1982195350
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Entity Type | Organization
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Legal Business Name | ARH EMPIRE CORP
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 6240 FOREST AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385
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Country | US
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Telephone | 718-418-0100
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Fax | 718-418-0005
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Provider Business Mailing Address
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Address Line | 6240 FOREST AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1929
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Country | US
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Telephone | 718-418-0100
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Fax | 718-418-0005
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Authorized Official
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Title or Position | MANAGER
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Name | MR. RAPHAEL YUSUPOV
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Credential |
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Telephone | 718-418-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 007920
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License Number State | NY
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