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Organization

FAMILY OPTICAL SHOPPE CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IZABELLA GUGILEV-CALIK OPTICIAN (PRESIDENT)
(718) 861-6009
Entity
Organization

Contact information

Practice address
1594 WESTCHESTER AVE, BRONX, NY 10472-2919
(718) 861-6009
(718) 861-6679
Mailing address
1594 WESTCHESTER AVE, BRONX, NY 10472-2919
(718) 861-6009
(718) 861-6679

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008120-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02529702
NY
01
27909
SPECTERA
NY
01
49756
DAVIS VISION
NY
01
4C9879
HEALTHNET
NY
01
906025
BLOCK VISION
NY
Enumeration date
06/04/2006
Last updated
02/26/2009
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