Organization Name: | EXCLUSIVE OPTICS |
NPI Number: | 1003176603 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANATE DAVIDOV (OPTHALMIC DISPENSER) |
Mailing Address: | 6830 Main St Flushing |
State: | NY US |
Postal Code: | 113671325 |
Phone Number: | 7185753937 |
Fax Number: | 7182612191 |
NPI Enumeration Date: | 05/17/2012 |
NPI Last Update Date: | 05/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 009250 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |