Organization
LENS LAB EXPRESS OF GRAHAM AVENUE INC
Active
Other names
General Vision Express
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CANDIDO DIAZ (PRESIDENT)
(718) 486-0120
Entity
Organization
Contact information
Practice address
28 GRAHAM AVENUE, BROOKLYN, NY 11206
(718) 486-0117
(718) 486-0120
Mailing address
28 GRAHAM AVENUE, BROOKLYN, NY 11206
(718) 486-0117
(718) 486-0120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T0029461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02045590
—
NY
Enumeration date
12/12/2006
Last updated
12/22/2016
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