Organization
RIVERDALE OPTOMETRY
Active
Other names
Riverdale Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNA VAYSTUB O.D. (MEMBER)
(718) 543-8066
Entity
Organization
Contact information
Practice address
219 W 231ST ST, BRONX, NY 10463-5301
(718) 543-8066
Mailing address
219 W 231ST ST, BRONX, NY 10463-5301
(718) 543-8066
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006447
NY
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02717311
—
NY
Enumeration date
07/10/2007
Last updated
07/10/2007
Update your record
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