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NPI Code Detail

MEDICARE: EYEGLASS SERVICE INDUSTRIES

MEDICARE: EYEGLASS SERVICE INDUSTRIES
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
1156FX1800XOptician005020-1NY

General Provider Information

NPI Number : 1811971203
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYEGLASS SERVICE INDUSTRIES
Provider Business Mailing Address
First Line : 700 ROUTE 101
Second Line : 20
City : MEDFORD
State : NY
Zip : 11763-2206
Country : US
Telephone Number : 631-924-5188
Fax Number : 631-205-1034
Provider Business Practice Location Address
First Line : 700 ROUTE 101
Second Line : 20
City : MEDFORD
State : NY
Zip : 11763-2206
Country : US
Telephone Number : 631-924-5188
Fax Number : 631-205-1034
Authorized Official
Title or Position : OWNER
Name : DR. BRUCE TOPOL
Credential : O.D.
Telephone Number : 516-599-1135
Provider Enumeration Date : 11/30/2005
Last Update Date : 08/22/2020

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Directions to “EYEGLASS SERVICE INDUSTRIES ” 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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