Organization
KELLY'S FASHION OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN I HERNANDEZ-RIVERA OPTHALMIC DISPENSER (OWNER)
(718) 618-7543
Entity
Organization
Contact information
Practice address
529 E 138TH ST, BRONX, NY 10454-4925
(718) 618-7443
(718) 618-7545
Mailing address
529 E 138TH ST, BRONX, NY 10454-4925
(718) 618-7443
(718) 618-7545
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
—
—
156FX1800X
Optician
Primary
008692
NY
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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