1104081041 NPI number — COHEN'S FASHION OPTICAL

Table of content: (NPI 1104081041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104081041 NPI number — COHEN'S FASHION OPTICAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COHEN'S FASHION OPTICAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104081041
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 8TH AVE
Provider Second Line Business Mailing Address:
9TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-6507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-729-5300
Provider Business Mailing Address Fax Number:
212-729-5382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BROWARD MALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33388-0024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-472-4777
Provider Business Practice Location Address Fax Number:
954-472-1555
Provider Enumeration Date:
07/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COHEN
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
212-729-5300

Provider Taxonomy Codes

  • Taxonomy code: 305S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)