Organization
VIP OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENNY TEMIRYAYEV O.D. (OWNER)
(718) 621-1624
Entity
Organization
Contact information
Practice address
1916 86TH ST, BROOKLYN, NY 11214-3104
(718) 621-1624
Mailing address
1916 86TH ST, BROOKLYN, NY 11214-3104
(718) 621-1624
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008486
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03154029
—
NY
Enumeration date
06/02/2009
Last updated
08/26/2011
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