Organization
MY UNIQUE OPTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ILYA DAVIDSON OPTICIAN (PRESIDENT)
(347) 592-7373
Entity
Organization
Contact information
Practice address
324 ATLANTIC AVENUE, BROOKLYN, NY 11201
(718) 624-6700
(718) 624-6701
Mailing address
324 ATLANTIC AVENUE, BROOKLYN, NY 11201
(718) 624-6700
(718) 624-6701
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008896-1
NY
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
Update your record
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