Organization · NPI-2

Astoria Vision Center INC

Optometrist · Astoria, NY

NPI number1356544266
StatusActive
Last updated in NPPESFeb 6, 2013

Details

NPI
1356544266
Entity type
Organization (NPI-2)
Legal business name
Astoria Vision Center INC
Organization subpart
No
Enumeration date
Jun 7, 2007
Last updated
Feb 6, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristT004992-1NYYes
156FX1800X Technician/Technologist, Optician006945-1NY

Practice location

3620 Broadway
Astoria, NY 11106-1046

Phone 718-204-2007 · Fax 718-204-2008

Mailing address

36-20 Broadway Ave
Astoria, NY 11106-1046

Phone 718-204-2007 · Fax 718-204-2008

Authorized official

Isaias Lope
Owner Optician
7182042007

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