Provider Demographics
NPI:1326774431
Name:KLARITY OPTICAL 2020 INC
Entity Type:Organization
Organization Name:KLARITY OPTICAL 2020 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BISRAITHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-982-9759
Mailing Address - Street 1:111 MERRICK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-3454
Mailing Address - Country:US
Mailing Address - Phone:917-982-9759
Mailing Address - Fax:
Practice Address - Street 1:111 MERRICK RD STE 3
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-3454
Practice Address - Country:US
Practice Address - Phone:917-982-9759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty