Provider Demographics
NPI:1164465282
Name:OCEANVIEW OPTICAL INC.
Entity Type:Organization
Organization Name:OCEANVIEW OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-339-9800
Mailing Address - Street 1:944 KINGS HWY
Mailing Address - Street 2:OCEAN VIEW OPTICAL INC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2338
Mailing Address - Country:US
Mailing Address - Phone:718-339-9800
Mailing Address - Fax:718-947-0306
Practice Address - Street 1:944 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2338
Practice Address - Country:US
Practice Address - Phone:718-339-9800
Practice Address - Fax:718-947-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005712156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0349220001Medicare NSC