Organization
E&I OPTICAL, INC
Active
Other names
Vision Palace
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGOR VALERY SUPITSKIY OPTICIAN (PRESIDENT)
(718) 998-8400
Entity
Organization
Contact information
Practice address
1723 AVENUE U, BROOKLYN, NY 11229-3811
(718) 998-8400
(718) 998-2500
Mailing address
1723 AVENUE U, BROOKLYN, NY 11229-3811
(718) 998-8400
(718) 998-2500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T006198
NY
156FX1800X
Optician
007691-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02491050
—
NY
Enumeration date
10/04/2006
Last updated
08/11/2008
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