Provider Demographics
NPI:1104031905
Name:OPTICS BY DSMB, INC
Entity Type:Organization
Organization Name:OPTICS BY DSMB, INC
Other - Org Name:TRAPP OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:914-337-0707
Mailing Address - Street 1:87 GREENWICH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5521
Mailing Address - Country:US
Mailing Address - Phone:203-552-1072
Mailing Address - Fax:203-552-9578
Practice Address - Street 1:87 GREENWICH AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5521
Practice Address - Country:US
Practice Address - Phone:203-552-1072
Practice Address - Fax:203-552-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0000985152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410000985OtherBCBS PROVIDER NUMBER