Provider Demographics
NPI:1356461859
Name:L&K OPTICAL, INC.
Entity Type:Organization
Organization Name:L&K OPTICAL, INC.
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-724-9055
Mailing Address - Street 1:124 SMITH HAVEN MALL
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-1214
Mailing Address - Country:US
Mailing Address - Phone:631-724-9055
Mailing Address - Fax:631-724-9142
Practice Address - Street 1:124 SMITH HAVEN MALL
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1214
Practice Address - Country:US
Practice Address - Phone:631-724-9055
Practice Address - Fax:631-724-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY TUV003919-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID#