Provider Demographics
NPI:1750433942
Name:LENS LAND OF ASTORIA
Entity type:Organization
Organization Name:LENS LAND OF ASTORIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-626-5184
Mailing Address - Street 1:1955 TURNBULL AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2516
Mailing Address - Country:US
Mailing Address - Phone:718-278-8780
Mailing Address - Fax:718-626-5405
Practice Address - Street 1:1955 TURNBULL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2516
Practice Address - Country:US
Practice Address - Phone:718-278-8780
Practice Address - Fax:718-626-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty