Organization
PLC OPTICAL CORP
Active
Other names
Manorville Eyecare Center
Organization subpart
No
Provider details
NPI number
Authorized official
PETER LACORTE (OWNER)
(917) 602-4139
Entity
Organization
Contact information
Practice address
460 COUNTY ROAD 111 UNIT 8, MANORVILLE, NY 11949-3375
(917) 602-4139
Mailing address
199 GOTHIC CIR, MANORVILLE, NY 11949-2622
(917) 602-4139
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11502510
CAQH
NY
Enumeration date
11/02/2018
Last updated
11/02/2018
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