Organization
EYES ON BROADWAY SA INC
Active
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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