Burnside Optical INC.
Technician/Technologist, Optician in Bronx, NY. Organization (NPI-2).
NPI number1568530079
StatusActive
Last updated in NPPESMar 5, 2012
Details
- NPI
- 1568530079
- Entity type
- Organization (NPI-2)
- Legal business name
- Burnside Optical INC.
- Organization subpart
- No
- Enumeration date
- Dec 1, 2006
- Last updated
- Mar 5, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 0073791 | NY | Yes |
Practice location
54 W Burnside AveBronx, NY 10453-4018
Phone 718-299-5454 · Fax 718-299-0770
Mailing address
54 W Burnside AveBronx, NY 10453-4018
Phone 718-299-5454 · Fax 718-299-0770
Authorized official
Guillermo Ysmael Reyes
President
7182995454
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