Organization
BRILLIANT VISION CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELEANORA MULLOKANDOVA (OPTICIAN)
(347) 840-3244
Entity
Organization
Contact information
Practice address
97-21 QUEENS BLVD, REGO PARK, NY 11374
(347) 840-3244
Mailing address
97-21 QUEENS BLVD, REGO PARK, NY 11374
(347) 840-3244
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPTOMETRIST
—
156FX1800X
Optician
OPTICIAN
—
Other
Enumeration date
01/09/2013
Last updated
08/13/2013
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