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Organization

ATLANTIC OPTICAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ALLA DYATLOV OPTICIAN (OWNER)
(718) 522-3737
Entity
Organization

Contact information

Practice address
139 FLATBUSH AVE, #15, BROOKLYN, NY 11217-1450
(718) 522-3737
(718) 522-3894
Mailing address
139 FLATBUSH AVE, #15, BROOKLYN, NY 11217-1450
(718) 522-3737
(718) 522-3894

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006692
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02950223
NY
Enumeration date
10/29/2007
Last updated
08/07/2015
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