Provider Demographics
NPI:1215289525
Name:NEW STARLIGHT OPTICAL INC
Entity type:Organization
Organization Name:NEW STARLIGHT OPTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAYEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-787-4111
Mailing Address - Street 1:1501 GRAVESEND NECK RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4434
Mailing Address - Country:US
Mailing Address - Phone:718-787-4111
Mailing Address - Fax:718-787-4114
Practice Address - Street 1:1501 GRAVESEND NECK RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4434
Practice Address - Country:US
Practice Address - Phone:718-787-4111
Practice Address - Fax:718-787-4114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty