BOSCOVS DEPARTMENT STORE LLC NPI 1700710563

NPI Information

  • NPI: 1700710563
  • Provider Name: BOSCOVS DEPARTMENT STORE LLC
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Address: 22 CLIFTON COUNTRY RD
    CLIFTON PARK, NY
    ZIP 12065
  • Phone: (518) 383-9838

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NPI Details

BOSCOVS DEPARTMENT STORE LLC is an eyewear supplier in Clifton Park, NY. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. BOSCOVS DEPARTMENT STORE LLC NPI is 1700710563. The provider is registered as an organization entity type.

The provider's business location address is:

22 CLIFTON COUNTRY RD
CLIFTON PARK, NY
ZIP 12065-830
Phone: (518) 383-9838

The provider's authorized official is Michael Derenzo .
The authorized official title is Director Of Optical Services and has the following contact phone number (856) 759-9905.

The enumeration date for this NPI number is 6/9/2026 and was last updated on 6/9/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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