Provider Demographics
NPI:1811027022
Name:METRO OPTICS OF THE BRONX, INC.
Entity Type:Organization
Organization Name:METRO OPTICS OF THE BRONX, INC.
Other - Org Name:OPTIC ZONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-402-8300
Mailing Address - Street 1:2882 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-2640
Mailing Address - Country:US
Mailing Address - Phone:718-402-8300
Mailing Address - Fax:718-402-5105
Practice Address - Street 1:2882 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-2640
Practice Address - Country:US
Practice Address - Phone:718-402-8300
Practice Address - Fax:718-402-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY TUV004289-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherEIN