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NPI Code Detail

MEDICARE: REGO PARK OPTICAL CORP

MEDICARE: REGO PARK 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
1332H00000XEyewear SupplierTUV006193NY

General Provider Information

NPI Number : 1659718518
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGO PARK OPTICAL CORP
Provider Business Mailing Address
First Line : 9519 63RD DR
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2024
Country : US
Telephone Number : 718-690-9542
Fax Number :
Provider Business Practice Location Address
First Line : 9519 63RD DR
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2024
Country : US
Telephone Number : 718-690-9542
Fax Number :
Authorized Official
Title or Position : MGR
Name : ELAINA ZAVILENSKY
Credential :
Telephone Number : 718-690-9542
Provider Enumeration Date : 05/31/2013
Last Update Date : 05/31/2013

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Directions to “REGO PARK OPTICAL CORP ” Practice Location

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