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NPI Code Detail

MEDICARE: JATS OPTICAL CO INC.

MEDICARE: JATS OPTICAL CO 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
1302F00000XExclusive Provider Organization004539-1NY

General Provider Information

NPI Number : 1699960963
Entity Type Code : Organization
Provider Name (Legal Business Name) : JATS OPTICAL CO INC.
Provider Business Mailing Address
First Line : 872 SUNRISE HWY
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-5908
Country : US
Telephone Number : 631-968-2727
Fax Number :
Provider Business Practice Location Address
First Line : 872 SUNRISE HWY
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-5908
Country : US
Telephone Number : 631-968-2727
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. STEVEN LESTER GARCIA
Credential : OPTICIAN
Telephone Number : 631-968-2727
Provider Enumeration Date : 09/10/2007
Last Update Date : 09/10/2007

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Directions to “JATS OPTICAL CO INC. ” Practice Location

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