Organization
OPT2GO OUTLET INC
Active
Organization
OPT2GO OUTLET INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE Q MIU (OWNER)
(917) 653-8836
Entity
Organization
Contact information
Practice address
219 CANAL ST FL 3, NEW YORK, NY 10013-4114
(646) 476-3021
Mailing address
219 CANAL ST FL 3, NEW YORK, NY 10013-4114
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
00-8841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
I AM APPLYING FOR MEDICAID, SO I DON'T KNOW THE ID NUMBER UNTIL I GET A NPI.
NY
05
—
00000000
—
NY
Enumeration date
06/18/2015
Last updated
06/18/2015
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