Organization
MAK OPTICAL OF NEW YORK INC
Active
Other names
Pearle Vision
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN E SMITH (MANAGER)
(718) 459-7100
Entity
Organization
Contact information
Practice address
6135 JUNCTION BLVD, REGO PARK, NY 11374-2771
(718) 459-7100
Mailing address
6135 JUNCTION BLVD, REGO PARK, NY 11374-2771
(718) 459-7100
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
NY7701
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01421416
—
NY
Enumeration date
09/21/2006
Last updated
07/10/2015
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