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NPI Code Detail

MEDICARE: BRIGHTON VISION CORP.

MEDICARE: BRIGHTON VISION 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
1152W00000XOptometristTUV007123NY

General Provider Information

NPI Number : 1841503547
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTON VISION CORP.
Provider Business Mailing Address
First Line : 274 BRIGHTON BEACH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-7411
Country : US
Telephone Number : 718-943-4777
Fax Number :
Provider Business Practice Location Address
First Line : 274 BRIGHTON BEACH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-7411
Country : US
Telephone Number : 718-943-4777
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. DAVID MALAYEV
Credential :
Telephone Number : 718-943-4777
Provider Enumeration Date : 07/22/2010
Last Update Date : 07/22/2010

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Directions to “BRIGHTON VISION CORP. ” Practice Location

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