| Lens Lab Optical 181 Inc | |
|
4250 Broadway, New York, NY 10033-3748 | |
| (212) 795-5640 | |
| (212) 927-6210 |
| Full Name | Lens Lab Optical 181 Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 4250 Broadway, 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 |
|---|---|---|---|
| 1356085393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Gauhar Kanimetova |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033604517 PECOS PAC ID: 5395082960 Enrollment ID: I20190122000913 |
| Mailing Address | Practice Location Address |
|---|---|
| Lens Lab Optical 181 Inc 4250 Broadway, New York, NY 10033-3748 Ph: (212) 795-5640 | Lens Lab Optical 181 Inc 4250 Broadway, New York, NY 10033-3748 Ph: (212) 795-5640 |
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