Provider Demographics
NPI:1003112509
Name:COHEN'S FASHION OPTICAL PUERTO RICO, INC
Entity Type:Organization
Organization Name:COHEN'S FASHION OPTICAL PUERTO RICO, INC
Other - Org Name:COHENS FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CETTINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-729-5373
Mailing Address - Street 1:520 8TH AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6507
Mailing Address - Country:US
Mailing Address - Phone:212-729-5373
Mailing Address - Fax:212-967-5927
Practice Address - Street 1:CAROLINA SHOPP CTR
Practice Address - Street 2:LOCAL 245
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5672
Practice Address - Country:US
Practice Address - Phone:787-701-3165
Practice Address - Fax:787-701-3168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
01252011OtherAPPLICATION DATE