Organization
SVC OF MASTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY S WILLIAMS OD (AUTHORIZED OFFICIAL/OWNER)
(631) 442-2442
Entity
Organization
Contact information
Practice address
1360 MONTAUK HWY, MASTIC, NY 11950-2929
(631) 727-2858
Mailing address
1224 OSTRANDER AVENUE, RIVERHEAD, NY 11901
(631) 727-2858
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
07/30/2020
Last updated
12/03/2020
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