Port Jefferson Opticians INC
NPI #1154443158 in Port Jefferson Station, New York
Provider Information
- NPI Number
- 1154443158
- Entity Type
- Organization
- Organization Name
- Port Jefferson Opticians INC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Apr 3, 2007
- Last Updated
- Sep 17, 2021
Practice Location
- Address
- 208 ROUTE 112 STE 2
- State
- New York
- ZIP Code
- 11776-1013
- Phone
- (631) 331-0600
Authorized Official
- Name
- MR. PAUL MASTROROCCO, OPTICIAN
- Title
- PRESIDENT/OPTICIAN
- Phone
- (631) 331-0600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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