Basic Information
| Provider Information | |||||||||
| NPI: | 1003139064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDEL | ||||||||
| FirstName: | PINCHUS | ||||||||
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| Credential: | OPHTHALMIC DISPENSER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 148 HOOPER ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112117902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188759000 | ||||||||
| FaxNumber: | 7188757331 | ||||||||
| Practice Location | |||||||||
| Address1: | 148 HOOPER ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112117902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188759000 | ||||||||
| FaxNumber: | 7188757331 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2010 | ||||||||
| LastUpdateDate: | 03/05/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 156FX1800X | 007594 | NY | Y | Eye and Vision Services Providers | Technician/Technologist | Optician |
No ID Information.