Organization
TERAGRAM II, INC
Active
Other names
STERLING OPTICAL SMITH HAVEN MALL
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET DERAGO (OWNER/PRESIDENT)
(631) 724-9055
Entity
Organization
Contact information
Practice address
124 SMITH HAVEN MALL, LAKE GROVE, NY 11755-1214
(631) 724-9055
Mailing address
124 SMITH HAVEN MALL, LAKE GROVE, NY 11755-1214
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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