Provider Demographics
NPI:1952014045
Name:BENJAMIN OPTICAL AD INC
Entity Type:Organization
Organization Name:BENJAMIN OPTICAL AD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PINCHES
Authorized Official - Middle Name:
Authorized Official - Last Name:DASKAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-731-5877
Mailing Address - Street 1:3315 NOSTRAND AVE APT L1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 AMERICAN DREAM WAY STE A160
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-2506
Practice Address - Country:US
Practice Address - Phone:201-482-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site