Provider Demographics
NPI:1407299027
Name:THE EYE STUDIO, INC.
Entity Type:Organization
Organization Name:THE EYE STUDIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-647-2020
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:5 LIBERTY ST.
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428-0468
Mailing Address - Country:US
Mailing Address - Phone:845-647-2020
Mailing Address - Fax:845-647-4734
Practice Address - Street 1:5 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-1430
Practice Address - Country:US
Practice Address - Phone:845-647-2020
Practice Address - Fax:845-647-4734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT0059141332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1942339387OtherNPI DR. LINA M. ESCOBAR
NYU73536Medicare UPIN