Provider Demographics
NPI:1891740122
Name:A.G. FASHION OPTICAL CORP
Entity Type:Organization
Organization Name:A.G. FASHION OPTICAL CORP
Other - Org Name:A.G. FASHION OPTICAL CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORON
Authorized Official - Middle Name:
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-294-0085
Mailing Address - Street 1:2 E BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4140
Mailing Address - Country:US
Mailing Address - Phone:718-294-0085
Mailing Address - Fax:
Practice Address - Street 1:2 E BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4140
Practice Address - Country:US
Practice Address - Phone:718-294-0085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty