Provider Demographics
NPI:1902108665
Name:DESIGNER OPTICAL OF STEINWAY STREET INC.
Entity Type:Organization
Organization Name:DESIGNER OPTICAL OF STEINWAY STREET INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:ABRAHAM
Authorized Official - Last Name:CHOAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-935-3252
Mailing Address - Street 1:3185 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3908
Mailing Address - Country:US
Mailing Address - Phone:347-935-3252
Mailing Address - Fax:347-935-3254
Practice Address - Street 1:3185 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3908
Practice Address - Country:US
Practice Address - Phone:347-935-3252
Practice Address - Fax:347-935-3254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6254305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service