Provider Demographics
NPI:1407100548
Name:HYDE YOUR EYES OPTICAL INC
Entity Type:Organization
Organization Name:HYDE YOUR EYES OPTICAL INC
Other - Org Name:PILDES OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-877-2980
Mailing Address - Street 1:2193 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6664
Mailing Address - Country:US
Mailing Address - Phone:212-877-2980
Mailing Address - Fax:212-877-0549
Practice Address - Street 1:2193 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6664
Practice Address - Country:US
Practice Address - Phone:212-877-2980
Practice Address - Fax:212-877-0549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-27
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005055152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty