Organization
PRIMARY GLASSES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE SUPITSKIY (PRESIDENT)
(917) 747-7122
Entity
Organization
Contact information
Practice address
3009 CHURCH AVE, BROOKLYN, NY 11226-4209
(347) 406-6300
Mailing address
3009 CHURCH AVE, BROOKLYN, NY 11226-4209
(347) 406-6300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008048
NY
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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