Provider Demographics
NPI:1114007374
Name:KAREN OPTICAL, INC.
Entity Type:Organization
Organization Name:KAREN OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-834-7717
Mailing Address - Street 1:412 FOX HUNT DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2538
Mailing Address - Country:US
Mailing Address - Phone:302-834-7717
Mailing Address - Fax:302-834-7701
Practice Address - Street 1:412 FOX HUNT DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2538
Practice Address - Country:US
Practice Address - Phone:302-834-7717
Practice Address - Fax:302-834-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE36160OtherDAVIS VISION
DE0000094522Medicaid
DE908036OtherBLOCK VISION
DE232701OtherOPTICHOICE
DE0383750001Medicare ID - Type UnspecifiedPROVIDER ID. NO.