Provider Demographics
NPI:1457692816
Name:DESIGNER OPTICAL OF YONKERS INC
Entity Type:Organization
Organization Name:DESIGNER OPTICAL OF YONKERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:BERTHI
Authorized Official - Last Name:CHOAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-513-3577
Mailing Address - Street 1:2196 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1406
Mailing Address - Country:US
Mailing Address - Phone:718-513-3577
Mailing Address - Fax:
Practice Address - Street 1:1 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-8313
Practice Address - Country:US
Practice Address - Phone:914-226-8706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6250156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty