Provider Demographics
NPI:1518362425
Name:SPECX GRAHAM, LLC
Entity Type:Organization
Organization Name:SPECX GRAHAM, LLC
Other - Org Name:COHENS' FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CRED MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-792-8149
Mailing Address - Street 1:56 GRAHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4067
Mailing Address - Country:US
Mailing Address - Phone:718-599-7474
Mailing Address - Fax:646-448-3327
Practice Address - Street 1:56 GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4067
Practice Address - Country:US
Practice Address - Phone:718-599-7474
Practice Address - Fax:646-448-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier