The Optical Source

NPI #1174731129 in Islandia, New York

Provider Information

NPI Number: 1174731129
Entity Type: Organization
Organization Name: The Optical Source
Primary Specialty: Optometrist
Enumeration Date: May 21, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1744 VETERANS MEMORIAL HIGHWAY
City: Islandia
State: New York
ZIP Code: 11749
Phone: (631) 348-4545

Authorized Official

Name: DR. ERNIE ALAN ROSEN, DO
Title: VICE PRESIDENT
Phone: (631) 348-4545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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