Organization
VISION HUB OF FREEPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS TAKHALOV OPTICIAN (OWNER)
(347) 418-2730
Entity
Organization
Contact information
Practice address
37 W MERRICK RD, FREEPORT, NY 11520-3826
(516) 962-9336
(516) 962-9284
Mailing address
37 W MERRICK RD, FREEPORT, NY 11520-3826
(516) 962-9336
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03962012
—
NY
Enumeration date
12/21/2022
Last updated
12/21/2022
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