| Fabulous Optical | |
|
200 W 125th St, New York, NY 10027 | |
| (917) 642-1035 | |
| Not Available |
| Full Name | Fabulous Optical |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 200 W 125th St, New York, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619456589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (New York) | Primary |
| Provider Name | Vivien Van Vu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528042751 PECOS PAC ID: 9335156116 Enrollment ID: I20060320000641 |
| Provider Name | Alissa Broder |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932846425 PECOS PAC ID: 4587047808 Enrollment ID: I20220819001146 |
| Mailing Address | Practice Location Address |
|---|---|
| Fabulous Optical 546 Nostrand Ave, Brooklyn, NY 11216-2013 Ph: (917) 642-1035 | Fabulous Optical 200 W 125th St, New York, NY 10027 Ph: (917) 642-1035 |
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