Organization
JLS OPTICAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ERICKSEN (ASSISTANT)
(718) 951-9800
Entity
Organization
Contact information
Practice address
5171 KINGS PLZ, BROOKLYN, NY 11234-5218
(718) 951-9800
(718) 252-3736
Mailing address
5171 KINGS PLZ, BROOKLYN, NY 11234-5218
(718) 951-9800
(718) 252-3736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002877
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01982883
—
NY
Enumeration date
11/20/2006
Last updated
07/23/2013
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