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NPI Code Detail

MEDICARE: IZE OPTIC INC

MEDICARE: IZE OPTIC 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
1156FX1800XOptician007028NY

General Provider Information

NPI Number : 1932249083
Entity Type Code : Organization
Provider Name (Legal Business Name) : IZE OPTIC INC
Provider Business Mailing Address
First Line : 59 PAGE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-2611
Country : US
Telephone Number : 718-948-9088
Fax Number :
Provider Business Practice Location Address
First Line : 59 PAGE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-2611
Country : US
Telephone Number : 718-948-9088
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MRS. ELIZABETH PORSHAY
Credential :
Telephone Number : 718-948-9682
Provider Enumeration Date : 02/07/2007
Last Update Date : 04/08/2015

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Directions to “IZE OPTIC INC ” Practice Location

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