Provider Demographics
NPI:1407595929
Name:LIDYA'S OPTICAL LLC
Entity Type:Organization
Organization Name:LIDYA'S OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OPTICIAN AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIDYA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAYBY-ZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-234-6115
Mailing Address - Street 1:289 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3512
Mailing Address - Country:US
Mailing Address - Phone:508-290-0050
Mailing Address - Fax:
Practice Address - Street 1:289 COUNTY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3512
Practice Address - Country:US
Practice Address - Phone:857-234-6115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty