Provider Demographics
NPI:1760536361
Name:57TH ST. OPTICAL CORP.
Entity Type:Organization
Organization Name:57TH ST. OPTICAL CORP.
Other - Org Name:COHEN'S FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OPHTHALMIC DISPENSER
Authorized Official - Phone:212-581-4967
Mailing Address - Street 1:40 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4001
Mailing Address - Country:US
Mailing Address - Phone:212-581-4967
Mailing Address - Fax:212-586-6296
Practice Address - Street 1:40 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4001
Practice Address - Country:US
Practice Address - Phone:212-581-4967
Practice Address - Fax:212-586-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003094332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier