Provider Demographics
NPI:1548736671
Name:DEO NY RETAIL 3 LLC
Entity Type:Organization
Organization Name:DEO NY RETAIL 3 LLC
Other - Org Name:DEO NEW YORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-844-1433
Mailing Address - Street 1:2019 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2946
Mailing Address - Country:US
Mailing Address - Phone:646-512-0313
Mailing Address - Fax:
Practice Address - Street 1:128 MONTAGUE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3529
Practice Address - Country:US
Practice Address - Phone:347-844-1433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEO NEW YORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-16
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier