Organization · NPI-2

Mammoth Optical

Durable Medical Equipment & Medical Supplies · Stony Brook, NY

NPI number1487705018
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1487705018
Entity type
Organization (NPI-2)
Legal business name
Mammoth Optical
Organization subpart
No
Enumeration date
Jan 12, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332B00000X Durable Medical Equipment & Medical Supplies6197NYYes

Other names

  • Stony Brook Vision World (Doing Business As)

Practice location

2194 Nesconset Hwy Ste A
Stony Brook, NY 11790-3500

Phone 631-246-5468 · Fax 631-246-5442

Mailing address

2194 Nesconset Hwy Ste A
Stony Brook, NY 11790-3500

Phone 631-246-5468 · Fax 631-246-5442

Authorized official

Andrew Neil Polan
Presitdent
6312465468

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Durable Medical Equipment & Medical Supplies providers in Stony Brook, NY