Provider Demographics
NPI:1275853079
Name:UNIQUE OPTIQUE ON 2ND AVE. INC
Entity Type:Organization
Organization Name:UNIQUE OPTIQUE ON 2ND AVE. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOTRITSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-481-6690
Mailing Address - Street 1:430 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4002
Mailing Address - Country:US
Mailing Address - Phone:212-481-6690
Mailing Address - Fax:
Practice Address - Street 1:430 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4002
Practice Address - Country:US
Practice Address - Phone:212-481-6690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7557-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier