Mineola Optical Boutique INC

NPI #1780720748 in Mineola, New York

Provider Information

NPI Number: 1780720748
Entity Type: Organization
Organization Name: Mineola Optical Boutique INC
Primary Specialty: Eyewear Supplier
Enumeration Date: Jan 29, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 330 OLD COUNTRY RD
Address 2: SUITE 100
City: Mineola
State: New York
ZIP Code: 11501-4187
Phone: (516) 248-5554

Authorized Official

Name: MR. PETER A. BACOTTI, OPHTHALMIC DISPENSER
Title: MANAGER
Phone: (516) 248-5554

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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