Provider Demographics
NPI:1083338164
Name:SPECTACLES BY CATALPA LLC
Entity Type:Organization
Organization Name:SPECTACLES BY CATALPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSUPOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-366-3871
Mailing Address - Street 1:857 SENECA AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-4844
Mailing Address - Country:US
Mailing Address - Phone:718-366-3871
Mailing Address - Fax:718-366-3905
Practice Address - Street 1:857 SENECA AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-4844
Practice Address - Country:US
Practice Address - Phone:718-366-3871
Practice Address - Fax:718-366-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier