Provider Demographics
NPI:1700493020
Name:E & P OPTICAL CORP
Entity Type:Organization
Organization Name:E & P OPTICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD PRES
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSEV
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-241-0400
Mailing Address - Street 1:2103 RALPH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5405
Mailing Address - Country:US
Mailing Address - Phone:718-241-0400
Mailing Address - Fax:718-968-6854
Practice Address - Street 1:2103 RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5405
Practice Address - Country:US
Practice Address - Phone:718-241-0400
Practice Address - Fax:718-968-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center