Organization
OCEAN VIEW OPTICAL 5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANATOLIY KAGAN OPTHALMIC DISPENCER (OWNER)
17185966596
Entity
Organization
Contact information
Practice address
453 FULTON ST, BROOKLYN, NY 11201-5207
(718) 596-6596
(718) 596-6596
Mailing address
453 FULTON ST, BROOKLYN, NY 11201-5207
(718) 596-6596
(718) 596-6596
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
C006785-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01729822
—
NY
Enumeration date
03/22/2016
Last updated
03/22/2016
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