Provider Demographics
NPI:1447854658
Name:THE NEW FASHION IN OPTICS
Entity type:Organization
Organization Name:THE NEW FASHION IN OPTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAPHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-633-5511
Mailing Address - Street 1:4709 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2602
Mailing Address - Country:US
Mailing Address - Phone:718-633-5511
Mailing Address - Fax:
Practice Address - Street 1:4709 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2602
Practice Address - Country:US
Practice Address - Phone:718-633-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004428OtherOPHTHALMIC DISPENSING