1659499648 NPI number — COHEN'S FASHION OPTICAL OF PUERTO RICO, INC

Table of content: (NPI 1659499648)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659499648 NPI number — COHEN'S FASHION OPTICAL OF PUERTO RICO, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COHEN'S FASHION OPTICAL OF PUERTO RICO, INC
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:
6
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:
1659499648
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2016
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:
SUITE 901
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:
212-729-5373
Provider Business Mailing Address Fax Number:
212-967-5927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PLAZA LAS AMERICAS
Provider Second Line Business Practice Location Address:
#186
Provider Business Practice Location Address City Name:
HATO REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-777-0990
Provider Business Practice Location Address Fax Number:
787-274-0747
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CETTINA
Authorized Official First Name:
DARLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
212-729-5373

Provider Taxonomy Codes

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

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





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