NPI 1124487616

Bodim Optical INC

Organisation Point of Service Elmont, NY

Practice location

Address: 1445 Hempstead Tpke, Elmont, NY 11003-2400
Phone: (516) 616-1771

Authorised official

Name: Boaz Ben-Jacob
Title: Ophthalmic Dispenser
Phone: (516) 616-1771

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 007987 (NY)

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Registry record

NPI: 1124487616
Entity type: Organization
NPI issued: 12 Feb 2016
Record last updated: 12 Feb 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.