Provider Demographics
NPI:1326234386
Name:LOOKING GOOD OPTICAL, INC.
Entity Type:Organization
Organization Name:LOOKING GOOD OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:EISNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-634-0696
Mailing Address - Street 1:186 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3318
Mailing Address - Country:US
Mailing Address - Phone:845-634-0696
Mailing Address - Fax:845-634-3938
Practice Address - Street 1:186 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3318
Practice Address - Country:US
Practice Address - Phone:845-634-0696
Practice Address - Fax:845-634-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2837152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0268040001Medicare NSC
NYA100021910Medicare PIN