Provider Demographics
NPI:1225076300
Name:OPTICS PLUS OPTICIANS, INC.
Entity Type:Organization
Organization Name:OPTICS PLUS OPTICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:516-367-2020
Mailing Address - Street 1:8285 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1807
Mailing Address - Country:US
Mailing Address - Phone:516-367-2020
Mailing Address - Fax:516-367-3379
Practice Address - Street 1:8285 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1807
Practice Address - Country:US
Practice Address - Phone:516-367-2020
Practice Address - Fax:516-367-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004491152W00000X
NY004024156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4024OtherEYEMED PROVIDER NUMBER
NYC45021Medicare UPIN
NY4024OtherEYEMED PROVIDER NUMBER