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NPI Code Detail

MEDICARE: EYES & OPTICS GRAND INC

MEDICARE: EYES & OPTICS GRAND 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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1700272275
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYES & OPTICS GRAND INC
Provider Business Mailing Address
First Line : 213 E FORDHAM RD
Second Line :
City : BRONX
State : NY
Zip : 10458-5014
Country : US
Telephone Number : 718-562-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2922 AVENUE L
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4639
Country : US
Telephone Number : 718-513-6911
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : JENNY RUBIN
Credential :
Telephone Number : 718-926-3804
Provider Enumeration Date : 04/12/2015
Last Update Date : 04/12/2015

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