Provider Demographics
NPI:1235376203
Name:CATHERINE OPTICAL CENTER
Entity Type:Organization
Organization Name:CATHERINE OPTICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-234-7494
Mailing Address - Street 1:3354 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-7401
Mailing Address - Country:US
Mailing Address - Phone:212-234-7494
Mailing Address - Fax:212-234-8060
Practice Address - Street 1:3354 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7401
Practice Address - Country:US
Practice Address - Phone:212-234-7494
Practice Address - Fax:212-234-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier