Organization
CRESTON OPTICIANS INC
Active
Other names
Creston Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS T BERGER OPTICIAN (MGR)
(718) 409-2200
Entity
Organization
Contact information
Practice address
2169 WHITE PLAINS RD, BRONX, NY 10462-1405
(718) 409-2200
Mailing address
2169 WHITE PLAINS RD, BRONX, NY 10462-1405
(718) 409-2200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT002933-1
NY
152WC0802X
Corneal and Contact Management Optometrist
VUT002933-1
NY
152WL0500X
Low Vision Rehabilitation Optometrist
VUT002933-1
NY
152WS0006X
Sports Vision Optometrist
VUT002933-1
NY
152WX0102X
Occupational Vision Optometrist
VUT002933-1
NY
156FC0800X
Contact Lens Technician/Technologist
005104-1
NY
156FC0801X
Contact Lens Fitter
005104-1
NY
156FX1800X
Optician
005104-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00328267
—
NY
Enumeration date
01/03/2007
Last updated
01/28/2008
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