Provider Demographics
NPI:1851713101
Name:COUTURE OPTICAL NYC, INC.
Entity Type:Organization
Organization Name:COUTURE OPTICAL NYC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ODESSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-975-4824
Mailing Address - Street 1:2313 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4045
Mailing Address - Country:US
Mailing Address - Phone:718-975-4824
Mailing Address - Fax:718-975-4823
Practice Address - Street 1:2313 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4045
Practice Address - Country:US
Practice Address - Phone:718-975-4824
Practice Address - Fax:718-975-4823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty