Provider Demographics
NPI:1235508771
Name:NEW OPTICAL CORP
Entity Type:Organization
Organization Name:NEW OPTICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-785-3374
Mailing Address - Street 1:COND SIERRA BAYAMON
Mailing Address - Street 2:7-13 NORTH MAIN SUITE 1
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4201
Mailing Address - Country:US
Mailing Address - Phone:787-785-3374
Mailing Address - Fax:
Practice Address - Street 1:RES SIERRA BAYAMON
Practice Address - Street 2:7-13 NORTH MAIN SUITE 1
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4201
Practice Address - Country:US
Practice Address - Phone:787-785-3374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service