Provider Demographics
NPI:1326622804
Name:LAURA BERZINS OPTOMETRIST PC
Entity Type:Organization
Organization Name:LAURA BERZINS OPTOMETRIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERZINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-757-0404
Mailing Address - Street 1:164 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4322
Mailing Address - Country:US
Mailing Address - Phone:516-439-4951
Mailing Address - Fax:
Practice Address - Street 1:164 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4322
Practice Address - Country:US
Practice Address - Phone:516-439-4951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty