Provider Demographics
NPI:1417179649
Name:INSIGHT OPTICAL, LLC
Entity Type:Organization
Organization Name:INSIGHT OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PURISCH
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:718-596-3740
Mailing Address - Street 1:306 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4336
Mailing Address - Country:US
Mailing Address - Phone:718-596-3740
Mailing Address - Fax:718-596-4023
Practice Address - Street 1:306 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4336
Practice Address - Country:US
Practice Address - Phone:718-596-3740
Practice Address - Fax:718-596-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005343156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02253294Medicaid
NYA100045230OtherMEDICARE EXAMS
NY4269730001Medicare ID - Type Unspecified
NYA100045230OtherMEDICARE EXAMS