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NPI Code Detail

MEDICARE: GOOD LOOKING OPTICAL CORP

MEDICARE: GOOD LOOKING OPTICAL CORP
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1275871824
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOOD LOOKING OPTICAL CORP
Provider Business Mailing Address
First Line : 2655 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5821
Country : US
Telephone Number : 718-698-6666
Fax Number :
Provider Business Practice Location Address
First Line : 2655 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5821
Country : US
Telephone Number : 718-698-6666
Fax Number :
Authorized Official
Title or Position : ASSISTANT
Name : MICHELLE ERICKSEN
Credential :
Telephone Number : 718-698-6666
Provider Enumeration Date : 01/16/2013
Last Update Date : 08/28/2013

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Directions to “GOOD LOOKING OPTICAL CORP ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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