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NPI Code Detail

MEDICARE: E&I OPTICAL, INC

MEDICARE: E&I OPTICAL, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician007691-1NY
2152W00000XOptometristT006198NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164518577
Entity Type Code : Organization
Provider Name (Legal Business Name) : E&I OPTICAL, INC
Provider Business Mailing Address
First Line : 1723 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3811
Country : US
Telephone Number : 718-998-8400
Fax Number : 718-998-2500
Provider Business Practice Location Address
First Line : 1723 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3811
Country : US
Telephone Number : 718-998-8400
Fax Number : 718-998-2500
Authorized Official
Title or Position : PRESIDENT
Name : MR. IGOR VALERY SUPITSKIY
Credential : OPTICIAN
Telephone Number : 718-998-8400
Provider Enumeration Date : 10/04/2006
Last Update Date : 08/11/2008

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Directions to “E&I OPTICAL, INC ” Practice Location

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