Organization
4501 NYC OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NARGIZA SOBIROVA (CREDENTIALING SPECIALIST)
(718) 934-6714
Entity
Organization
Contact information
Practice address
4501 5TH AVE, BROOKLYN, NY 11220-1205
(917) 847-3457
Mailing address
4501 5TH AVE, BROOKLYN, NY 11220-1205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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