Organization
ROOSEVELT FIELD VISION EXPRESS, LLC
Active
Other names
Ultimate Spectacle
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID VAYNER (PRESIDENT)
(917) 748-1570
Entity
Organization
Contact information
Practice address
630 OLD COUNTRY RD UNIT 493A, GARDEN CITY, NY 11530-3505
(917) 748-1570
Mailing address
630 OLD COUNTRY RD UNIT 493A, GARDEN CITY, NY 11530-3505
(917) 748-1570
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
005243
NY
Other
Enumeration date
08/17/2017
Last updated
07/21/2022
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