Provider Demographics
NPI:1306391602
Name:EYES & OPTICS FAMILY VISION CENTER LLC
Entity Type:Organization
Organization Name:EYES & OPTICS FAMILY VISION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARYEH
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-442-2727
Mailing Address - Street 1:1378 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-2003
Mailing Address - Country:US
Mailing Address - Phone:718-442-2727
Mailing Address - Fax:718-447-4300
Practice Address - Street 1:1378 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2003
Practice Address - Country:US
Practice Address - Phone:718-442-2727
Practice Address - Fax:718-447-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004963152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01165746Medicaid
NYU41734Medicare UPIN