Provider Demographics
NPI:1659694875
Name:COURAGEOUS OPTOMETRY PC
Entity Type:Organization
Organization Name:COURAGEOUS OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:FREILICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-245-8111
Mailing Address - Street 1:650 LEE BLVD
Mailing Address - Street 2:STERLING OPTICAL
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1100
Mailing Address - Country:US
Mailing Address - Phone:914-245-8111
Mailing Address - Fax:
Practice Address - Street 1:650 LEE BLVD
Practice Address - Street 2:STERLING OPTICAL
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-1100
Practice Address - Country:US
Practice Address - Phone:914-245-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty