Organization
JACKSON HEIGHTS OPTICAL INC
Active
Other names
Jackson Heights Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISAIAS LOPE (OWNER)
(718) 426-2725
Entity
Organization
Contact information
Practice address
83-25 37TH AVENUE, JACKSON HEIGHTS, NY 11372
(718) 426-2725
(718) 426-9748
Mailing address
58-27 198 STREET, FRESH MEADOWS, NY 11365
(718) 224-0315
(718) 426-9748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
TUV005864-1
NY
152W00000X
Optometrist
TUV006744-1
NY
152W00000X
Optometrist
TUV007098-1
NY
152W00000X
Optometrist
Primary
VUT005856
NY
156FX1800X
Optician
006945-1
NY
Other
Enumeration date
05/03/2007
Last updated
10/19/2007
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