Organization
LIBERTY OPTICAL CORP
Active
Other names
Fabulous Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BARAYEV (OWNER)
(718) 835-3400
Entity
Organization
Contact information
Practice address
12102 LIBERTY AVE, SOUTH RICHMOND HILL, NY 11419-2112
(718) 835-3400
Mailing address
12102 LIBERTY AVE, SOUTH RICHMOND HILL, NY 11419-2112
(718) 835-3400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007786
NY
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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