Provider Demographics
NPI:1366644866
Name:ZYSIK & ZYSIK, LTD.
Entity Type:Organization
Organization Name:ZYSIK & ZYSIK, LTD.
Other - Org Name:PINNACLE EYE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LACHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-872-4477
Mailing Address - Street 1:850 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5240
Mailing Address - Country:US
Mailing Address - Phone:419-872-4477
Mailing Address - Fax:
Practice Address - Street 1:850 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5240
Practice Address - Country:US
Practice Address - Phone:419-872-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4999T1869152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4207030001Medicare NSC
OHZY9301711Medicare ID - Type Unspecified