Organization
ASTORIA VISION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISAIAS LOPE (OWNER OPTICIAN)
(718) 204-2007
Entity
Organization
Contact information
Practice address
3620 BROADWAY, ASTORIA, NY 11106-1046
(718) 204-2007
(718) 204-2008
Mailing address
36-20 BROADWAY AVE, ASTORIA, NY 11106-1046
(718) 204-2007
(718) 204-2008
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T004992-1
NY
156FX1800X
Optician
006945-1
NY
Other
Enumeration date
06/07/2007
Last updated
02/06/2013
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