Provider Demographics
NPI:1225206048
Name:ELEGANT EYES OPTICAL CORP.
Entity Type:Organization
Organization Name:ELEGANT EYES OPTICAL CORP.
Other - Org Name:GENERAL VISION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOENIGSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-253-7700
Mailing Address - Street 1:2504 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5128
Mailing Address - Country:US
Mailing Address - Phone:718-253-7700
Mailing Address - Fax:718-253-4731
Practice Address - Street 1:2504 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5128
Practice Address - Country:US
Practice Address - Phone:718-253-7700
Practice Address - Fax:718-253-4731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier