Provider Demographics
NPI:1174685457
Name:SKYLIGHT OPTICAL INC.
Entity Type:Organization
Organization Name:SKYLIGHT OPTICAL INC.
Other - Org Name:VISION WORLD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-723-7392
Mailing Address - Street 1:971 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3211
Mailing Address - Country:US
Mailing Address - Phone:914-723-7392
Mailing Address - Fax:914-723-1004
Practice Address - Street 1:971 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3211
Practice Address - Country:US
Practice Address - Phone:914-723-7392
Practice Address - Fax:914-723-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04916332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100049040Medicare PIN
NY4024360001Medicare NSC