| |
164 E Route 59, Nanuet, NY 10954-2910 | |
(845) 623-8074 | |
(845) 623-4028 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 164 E Route 59, Nanuet, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538491188 | NPI | - | NPPES |
02082010 | Other | DATE APP WAS SUBMITTED |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
164 E Route 59, Nanuet, NY 10954-2910 Ph: (845) 623-8074 | 164 E Route 59, Nanuet, NY 10954-2910 Ph: (845) 623-8074 |