Provider Demographics
NPI:1114789310
Name:NSEA OPTICAL, INC.
Entity Type:Organization
Organization Name:NSEA OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-523-1221
Mailing Address - Street 1:669 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-5221
Mailing Address - Country:US
Mailing Address - Phone:781-245-5200
Mailing Address - Fax:781-246-3932
Practice Address - Street 1:669 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5221
Practice Address - Country:US
Practice Address - Phone:781-245-5200
Practice Address - Fax:781-246-3932
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH SUBURBAN EYE ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier