Provider Demographics
NPI:1033136973
Name:OPTISIGHT LTD.
Entity Type:Organization
Organization Name:OPTISIGHT LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-635-3904
Mailing Address - Street 1:52 OSWEGO ST
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-2437
Mailing Address - Country:US
Mailing Address - Phone:315-635-3904
Mailing Address - Fax:315-635-5525
Practice Address - Street 1:52 OSWEGO ST
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-2437
Practice Address - Country:US
Practice Address - Phone:315-635-3904
Practice Address - Fax:315-635-5525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152W00000X
NY15000001998237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01636415Medicaid
NY15000001998OtherHEARING AID DISPENSING
NY52259AMedicare ID - Type UnspecifiedMEDICARE PART B
NY01636415Medicaid