Organization
SUPREME EYECARE CENTER CORP
Active
Other names
Supreme Optical
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS BANGIYEV (OWNER)
(646) 321-5802
Entity
Organization
Contact information
Practice address
457 KNICKERBOCKER AVE, BROOKLYN, NY 11237-5107
(646) 321-5802
Mailing address
457 KNICKERBOCKER AVE, BROOKLYN, NY 11237-5107
(646) 321-5802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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