Organization
BONAFIDE OPTICIANS OF AVE L INC
Active
Organization
BONAFIDE OPTICIANS OF AVE L INC
Active
Other names
Bonafide Opticians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IQBAL VENJARA OPHTHALMIC DISPENSER (MANAGER)
(718) 444-3126
Entity
Organization
Contact information
Practice address
9508 AVENUE L, BROOKLYN, NY 11236-4811
(718) 444-3126
(718) 444-3126
Mailing address
9508 AVENUE L, BROOKLYN, NY 11236-4811
(718) 444-3126
(718) 444-3126
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
005083-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01501440
—
NY
Enumeration date
07/08/2006
Last updated
11/05/2012
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