Provider Demographics
NPI:1720419625
Name:ALEXANDRA & ETHAN, INC.
Entity Type:Organization
Organization Name:ALEXANDRA & ETHAN, INC.
Other - Org Name:COHEN'S FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ILYAYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-510-8601
Mailing Address - Street 1:385 FIFTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-510-8601
Mailing Address - Fax:212-510-8634
Practice Address - Street 1:385 FIFTH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-510-8601
Practice Address - Fax:212-510-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009263-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty