Organization
DAVIDOFF OPTICAL CENTER CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB DAVIDOV OPTICIAN (VICE PRESIDENT)
(718) 275-0955
Entity
Organization
Contact information
Practice address
9309 63RD DR, REGO PARK, NY 11374-2924
(718) 275-0955
(718) 275-3725
Mailing address
9309 63RD DR, REGO PARK, NY 11374-2924
(718) 275-0955
(718) 275-3725
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6154-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01463767
—
NY
Enumeration date
02/15/2008
Last updated
02/15/2008
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