Provider Demographics
NPI:1386812147
Name:EYES BY LULU
Entity type:Organization
Organization Name:EYES BY LULU
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-623-4166
Mailing Address - Street 1:75 W ROUTE 59
Mailing Address - Street 2:ROOM 1013
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2700
Mailing Address - Country:US
Mailing Address - Phone:845-623-4166
Mailing Address - Fax:845-627-1597
Practice Address - Street 1:75 W ROUTE 59
Practice Address - Street 2:ROOM 1013
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2700
Practice Address - Country:US
Practice Address - Phone:845-623-4166
Practice Address - Fax:845-627-1597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier