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Organization

EYES ON BROADWAY SA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STAN FUZAYLOV (OWNER)
(917) 412-3750
Entity
Organization

Contact information

Practice address
825 BROADWAY, NEW YORK, NY 10003
(212) 475-0999
Mailing address
825 BROADWAY, NEW YORK, NY 10003-4702
(212) 475-0999

Taxonomy

Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
10/16/2023
Last updated
10/16/2023
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