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Organization

BRENTWOOD VISION CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FRANK S LOFORTE (OWNER)
(631) 273-3335
Entity
Organization

Contact information

Practice address
601 SUFFOLK AVENUE, SUITE 1, BRENTWOOD, NY 11717-4309
(631) 273-3335
(631) 273-0310
Mailing address
601 SUFFOLK AVENUE, SUITE 1, BRENTWOOD, NY 11717-4309
(631) 273-3335
(631) 273-0310

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NY67930
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00461867
NY
Enumeration date
12/11/2006
Last updated
12/11/2007
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