Midcrest Optical Corporation
Optometrist in New York, NY. Organization (NPI-2).
NPI number1982805750
StatusActive
Last updated in NPPESOct 10, 2011
Details
- NPI
- 1982805750
- Entity type
- Organization (NPI-2)
- Legal business name
- Midcrest Optical Corporation
- Organization subpart
- No
- Enumeration date
- May 30, 2007
- Last updated
- Oct 10, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | VUT002933-1 | NY | Yes |
| 152WC0802X | Optometrist, Corneal and Contact Management | VUT002933-1 | NY | |
| 152WP0200X | Optometrist, Pediatrics | VUT002933-1 | NY | |
| 152WS0006X | Optometrist, Sports Vision | VUT002933-1 | NY | |
| 152WX0102X | Optometrist, Occupational Vision | VUT002933-1 | NY | |
| 156FC0801X | Technician/Technologist, Contact Lens Fitter | 5104-1 | NY | |
| 156FX1800X | Technician/Technologist, Optician | 005104-1 | NY | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | C005104-1 | NY |
Other names
- Creston Optical (Doing Business As)
Practice location
897 8th AveNew York, NY 10019-5154
Phone 212-582-5926
Mailing address
897 8th AveNew York, NY 10019-5154
Phone 212-582-5926
Authorized official
Douglas Berger
Director Of Operations
2125825926
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