Organization
MINEOLA OPTICAL BOUTIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER A. BACOTTI OPHTHALMIC DISPENSER (MANAGER)
(516) 248-5554
Entity
Organization
Contact information
Practice address
330 OLD COUNTRY RD, SUITE 100, MINEOLA, NY 11501-4187
(516) 248-5554
(516) 739-6620
Mailing address
330 OLD COUNTRY RD, SUITE 100, MINEOLA, NY 11501-4187
(516) 248-5554
(516) 739-6620
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
3126
NY
Other
Enumeration date
01/29/2007
Last updated
08/22/2020
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