Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1884 3rd Ave, New York, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033278544 | NPI | - | NPPES |
59C0310 | Other | NY | COMMUNITY PREMIER PLUS |
02687667 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1884 3rd Ave, New York, NY 10029 Ph: (212) 831-4733 | 1884 3rd Ave, New York, NY 10029 Ph: (212) 831-4733 |