Provider Demographics
NPI:1407894447
Name:OCEANVIEW OPTICAL #6 INC.
Entity Type:Organization
Organization Name:OCEANVIEW OPTICAL #6 INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-332-4704
Mailing Address - Street 1:1075 BRIGHTON BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5658
Mailing Address - Country:US
Mailing Address - Phone:718-332-4704
Mailing Address - Fax:718-615-4739
Practice Address - Street 1:1075 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5658
Practice Address - Country:US
Practice Address - Phone:718-332-4704
Practice Address - Fax:718-615-4739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0330480001Medicare NSC