Provider Demographics
NPI:1285867556
Name:A & A OPTICAL INC
Entity Type:Organization
Organization Name:A & A OPTICAL INC
Other - Org Name:MERMAID OPTICAL INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRICHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-265-6066
Mailing Address - Street 1:2819 MERMAID AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2068
Mailing Address - Country:US
Mailing Address - Phone:718-265-6066
Mailing Address - Fax:718-265-0665
Practice Address - Street 1:2819 MERMAID AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2068
Practice Address - Country:US
Practice Address - Phone:718-265-6066
Practice Address - Fax:718-265-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005465-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6495020001Medicare NSC
NYA100017488Medicare PIN