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General NPI Number Information
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NPI Number | 1992746358
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Entity Type | Organization
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Legal Business Name | BR-EYES LTD
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 1174A WANTAGH AVE
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City | WANTAGH
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State | NY
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Zip | 11793-2110
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Country | US
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Telephone | 516-221-2220
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Fax | 516-221-2228
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Provider Business Mailing Address
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Address Line | 1174A WANTAGH AVE
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City | WANTAGH
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State | NY
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Zip | 11793-2110
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Country | US
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Telephone | 516-221-2220
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Fax | 516-221-2228
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. BRIAN FRISCHER
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Credential | OPHTHALMIC DISPENSER
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Telephone | 516-221-2220
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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 | VUT005770
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T005875-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 6585
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT004589-1
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License Number State | NY
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