Organization
EVAN DAVID OPTICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVAN ROMAINE OPTICIAN (CEO)
(718) 805-2020
Entity
Organization
Contact information
Practice address
9008 JAMAICA AVE, WOODHAVEN, NY 11421-2103
(718) 805-2020
(718) 805-2020
Mailing address
9008 JAMAICA AVE, WOODHAVEN, NY 11421-2103
(718) 805-2020
(718) 805-2020
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01615012
—
NY
Enumeration date
04/19/2006
Last updated
08/22/2020
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