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General NPI Number Information
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NPI Number | 1982887519
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Entity Type | Organization
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Legal Business Name | OUTLOOK OPTICAL INC
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 888 WILLIS AVE
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City | ALBERTSON
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State | NY
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Zip | 11507-1923
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Country | US
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Telephone | 516-747-6363
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Fax |
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Provider Business Mailing Address
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Address Line | 888 WILLIS AVE
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City | ALBERTSON
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State | NY
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Zip | 11507-1923
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. BRUCE FARBER
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Credential |
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Telephone | 516-747-6363
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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 |
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License Number State |
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