Organization
MAZ OPTICAL, INC
Active
Other names
Maz Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN A PEPPERS (PRESIDENT)
(631) 447-1300
Entity
Organization
Contact information
Practice address
655 MONTAUK HIGHWAY, SUITE 29, EAST PATCHOGUE, NY 11772
(631) 447-1300
(631) 447-1302
Mailing address
655 MONTAUK HWY, SUITE 29, EAST PATCHOGUE, NY 11772-4733
(631) 447-1300
(631) 447-1302
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
VUT003894
NY
332H00000X
Eyewear Supplier
Primary
5877-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
333670
NVA
—
01
—
5400044
GHI
NY
Enumeration date
01/08/2007
Last updated
03/03/2014
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