Provider Demographics
NPI:1699011502
Name:EYE ATTIRE OF NEWYORK
Entity Type:Organization
Organization Name:EYE ATTIRE OF NEWYORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O. , OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:COATS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-350-1585
Mailing Address - Street 1:700 BROADWAY UNIT 38
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2236
Mailing Address - Country:US
Mailing Address - Phone:516-350-1585
Mailing Address - Fax:
Practice Address - Street 1:59C MERRICK ROAD
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2236
Practice Address - Country:US
Practice Address - Phone:516-350-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009230332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier