Provider Demographics
NPI:1619386372
Name:U SPECTACLE RETAIL, LLC
Entity Type:Organization
Organization Name:U SPECTACLE RETAIL, LLC
Other - Org Name:ULTIMATE SPECTACLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-792-8149
Mailing Address - Street 1:789 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8163
Mailing Address - Country:US
Mailing Address - Phone:212-792-8149
Mailing Address - Fax:646-448-3327
Practice Address - Street 1:789 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8163
Practice Address - Country:US
Practice Address - Phone:212-792-8149
Practice Address - Fax:646-448-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier