Provider Demographics
NPI:1780091272
Name:MANHATTAN OPTOMETRY AND OPHTHALMIC DISPENSING PLLC
Entity type:Organization
Organization Name:MANHATTAN OPTOMETRY AND OPHTHALMIC DISPENSING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-373-8510
Mailing Address - Street 1:187 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3741
Mailing Address - Country:US
Mailing Address - Phone:718-373-2020
Mailing Address - Fax:
Practice Address - Street 1:400 W 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6809
Practice Address - Country:US
Practice Address - Phone:212-430-2020
Practice Address - Fax:212-594-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006404152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty