Organization
WYNN OPTICS CORP
Active
Other names
WYNN OPITCS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEJUAN LAMONT WYNN OPTICIAN (OWNER)
(212) 222-6048
Entity
Organization
Contact information
Practice address
167 MALCOLM X BLVD, NEW YORK, NY 10026-1320
(212) 222-6048
(212) 222-6606
Mailing address
167 MALCOLM X BLVD, NEW YORK, NY 10026-1320
(212) 222-6048
(212) 222-6606
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
164759
NY
Other
Enumeration date
02/13/2007
Last updated
02/23/2010
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