Organization
ULTIMATE SPECTACLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA VALENTIN (CREDENTIALING SPECIALIST)
(212) 792-8149
Entity
Organization
Contact information
Practice address
789 LEXINGTON AVE, NEW YORK, NY 10065-8163
(212) 792-8123
(212) 355-3515
Mailing address
789 LEXINGTON AVE, NEW YORK, NY 10065-8163
(212) 792-8123
(212) 355-3515
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/06/2012
Last updated
03/12/2012
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