Organization
BROOKHAVEN OPTICIANS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MASTROROCCO (OPTICIAN)
(631) 265-5767
Entity
Organization
Contact information
Practice address
79 E MAIN ST STE D, SMITHTOWN, NY 11787-2867
(631) 265-5767
(631) 265-9624
Mailing address
79 E MAIN ST STE D, SMITHTOWN, NY 11787-2867
(631) 265-5767
(631) 265-9624
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
C0058551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00342952
—
NY
Enumeration date
03/23/2007
Last updated
05/24/2024
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