Organization
EAST MAIN STREET OPTICIANS INC.
Active
Other names
Brookhaven Opticians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL MASTROROCCO OPTICIAN (PRESIDENT OPTICIAN)
(631) 553-6747
Entity
Organization
Contact information
Practice address
180 E MAIN ST STE 4, PATCHOGUE, NY 11772-3171
(631) 475-5030
(631) 475-5037
Mailing address
180 EAST MAIN STREET, SUITE 4, PATCHOGUE, NY 11772
(631) 475-5030
(631) 475-5037
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
C0058551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00683849
—
NY
Enumeration date
03/23/2007
Last updated
09/17/2021
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