Organization
ESAD OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISA F DE JUNCO OD (PRESIDENT)
(516) 641-1768
Entity
Organization
Contact information
Practice address
6332 NORTHERN BLVD, EAST NORWICH, NY 11732-1600
(516) 624-3149
Mailing address
708 SEABURY AVE, FRANKLIN SQUARE, NY 11010-4112
(516) 641-1768
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV004987
NY
152WC0802X
Corneal and Contact Management Optometrist
TUV004987
NY
152WS0006X
Sports Vision Optometrist
TUV004987
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03239461
—
NY
Enumeration date
02/27/2018
Last updated
06/16/2018
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