Provider Demographics
NPI:1780140814
Name:CFO RETAIL OF LONG ISLAND LLC
Entity type:Organization
Organization Name:CFO RETAIL OF LONG ISLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-729-5384
Mailing Address - Street 1:630 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3467
Mailing Address - Country:US
Mailing Address - Phone:516-294-0011
Mailing Address - Fax:516-294-2916
Practice Address - Street 1:630 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3467
Practice Address - Country:US
Practice Address - Phone:516-294-0011
Practice Address - Fax:516-294-2916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier