Provider Demographics
NPI:1013140466
Name:JMB OPTICAL
Entity Type:Organization
Organization Name:JMB OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:BERISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-637-6512
Mailing Address - Street 1:2 SKILLMAN STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1551
Mailing Address - Country:US
Mailing Address - Phone:718-637-6512
Mailing Address - Fax:
Practice Address - Street 1:2 SKILLMAN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1551
Practice Address - Country:US
Practice Address - Phone:718-637-6512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier