Provider Demographics
NPI:1295019305
Name:A&E OPTICAL, CORP
Entity Type:Organization
Organization Name:A&E OPTICAL, CORP
Other - Org Name:COHEN'S FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-990-2020
Mailing Address - Street 1:33 BERDON WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4643
Mailing Address - Country:US
Mailing Address - Phone:508-990-2020
Mailing Address - Fax:508-990-2089
Practice Address - Street 1:33 BERDON WAY
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4643
Practice Address - Country:US
Practice Address - Phone:508-990-2020
Practice Address - Fax:508-990-2089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5629332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier