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Organization

INTERMED OPTICAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LENNY TEMIRYAYEV O.D. (PRESIDENT)
(718) 621-1624
Entity
Organization

Contact information

Practice address
1849 86TH ST, BROOKLYN, NY 11214-3108
(718) 621-1624
Mailing address
1849 86TH ST, BROOKLYN, NY 11214-3108
(718) 621-1624

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0084861
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02323655
NY
Enumeration date
11/30/2006
Last updated
08/22/2020
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