Provider Demographics
NPI:1790076933
Name:CHEAPER PEEPERS OF NEW YORK MDIV, INC
Entity Type:Organization
Organization Name:CHEAPER PEEPERS OF NEW YORK MDIV, INC
Other - Org Name:CHEAPER PEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:5168-525-2473
Mailing Address - Street 1:1441 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4614
Mailing Address - Country:US
Mailing Address - Phone:516-502-4552
Mailing Address - Fax:516-502-4554
Practice Address - Street 1:1441 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4614
Practice Address - Country:US
Practice Address - Phone:516-502-4552
Practice Address - Fax:516-502-4554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2583332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier