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Organization
VISION PALACE II, INC
Active
Organization
VISION PALACE II, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGOR VALERY SUPITSKIY OPHTHALMIC DISPENSER (PRESIDENT)
(718) 648-2020
Entity
Organization
Contact information
Practice address
2027 EMMONS AVE, BROOKLYN, NY 11235-2781
(718) 648-2020
(718) 648-2006
Mailing address
2027 EMMONS AVE, BROOKLYN, NY 11235-2781
(718) 648-2020
(718) 648-2006
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006530-1
NY
Other
Enumeration date
06/28/2007
Last updated
04/21/2009
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