Provider Demographics
NPI:1720802804
Name:PUMPKIN EYEWEAR CORP
Entity type:Organization
Organization Name:PUMPKIN EYEWEAR CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-304-4629
Mailing Address - Street 1:300 MERCER ST APT 24M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6740
Mailing Address - Country:US
Mailing Address - Phone:845-304-4629
Mailing Address - Fax:
Practice Address - Street 1:2136 BARTOW AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4630
Practice Address - Country:US
Practice Address - Phone:718-671-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier