Organization
BAZAN OPTOMETRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BAZAN O.D. (OWNER)
(646) 496-7365
Entity
Organization
Contact information
Practice address
815 HUTCHINSON RIVER PKWY, INSIDE TARGET OPTICAL, BRONX, NY 10465-1887
(718) 822-2305
Mailing address
682 UNION ST, PARK SLOPE EYE, BROOKLYN, NY 11215-2047
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006867
NY
Other
Enumeration date
01/07/2015
Last updated
08/06/2015
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