Organization
BAYSIDE FAMILY EYECARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRASLAV FAYZAKOV (OWNER)
(347) 556-0903
Entity
Organization
Contact information
Practice address
20836 CROSS ISLAND PKWY, BAYSIDE, NY 11360-1187
(718) 224-1833
(718) 224-1877
Mailing address
20836 CROSS ISLAND PKWY, BAYSIDE, NY 11360-1187
(718) 224-1833
(718) 224-1877
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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