Organization · NPI-2

5623 Nyc Optical LLC

Optometrist · Brooklyn, NY

NPI number1043072770
StatusActive
Last updated in NPPESJan 20, 2025

Details

NPI
1043072770
Entity type
Organization (NPI-2)
Legal business name
5623 Nyc Optical LLC
Organization subpart
No
Enumeration date
Jan 29, 2024
Certification date
Jan 20, 2025
Last updated
Jan 20, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist––Yes

Practice location

5623 5th Ave
Brooklyn, NY 11220-3414

Phone 718-635-9333 · Fax 718-765-1113

Mailing address

5623 5th Ave
Brooklyn, NY 11220-3414

Phone 718-635-9333 · Fax 718-765-1113

Authorized official

Elena Pak
Manager
9299246019

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