Organization
RAPHAEL OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB DAVIDOV OPTICIAN (PRESIDENT/MANAGER)
(718) 456-2752
Entity
Organization
Contact information
Practice address
303 WYCKOFF AVE, BROOKLYN, NY 11237-5805
(718) 456-2752
(718) 456-2753
Mailing address
303 WYCKOFF AVE, BROOKLYN, NY 11237-5805
(718) 456-2752
(718) 456-2753
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01463758
—
NY
Enumeration date
02/14/2020
Last updated
02/14/2020
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