Provider Demographics
NPI:1114222866
Name:LULUEYEZ
Entity Type:Organization
Organization Name:LULUEYEZ
Other - Org Name:VISION WORLD OF NANUET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-623-4166
Mailing Address - Street 1:209 W ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2218
Mailing Address - Country:US
Mailing Address - Phone:845-623-4166
Mailing Address - Fax:
Practice Address - Street 1:209 W ROUTE 59
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2218
Practice Address - Country:US
Practice Address - Phone:845-623-4166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier