| |
971 Main St, Suite D, Holbrook, NY 11741-1609 | |
(631) 471-0600 | |
(631) 883-3365 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 971 Main St, Holbrook, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871725754 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | 5877-1 (New York) | Primary |
Mailing Address | Practice Location Address |
---|---|
971 Main St, Suite D, Holbrook, NY 11741-1609 Ph: (631) 471-0600 | 971 Main St, Suite D, Holbrook, NY 11741-1609 Ph: (631) 471-0600 |