Organization
HILLSIDE OPTICAL CORP.
Active
Other names
Fabulous Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BANGIYEV (OWNER)
(718) 658-0900
Entity
Organization
Contact information
Practice address
8902 165TH ST, JAMAICA, NY 11432-5126
(718) 658-0900
Mailing address
8902 165TH ST, JAMAICA, NY 11432-5126
(718) 658-0900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007405
NY
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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