Provider Demographics
NPI:1427397272
Name:OPTI-TECH LLC
Entity Type:Organization
Organization Name:OPTI-TECH LLC
Other - Org Name:COLUMBIA DISPENSARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-305-8310
Mailing Address - Street 1:128 LEUNING ST
Mailing Address - Street 2:
Mailing Address - City:S HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07606-1317
Mailing Address - Country:US
Mailing Address - Phone:212-305-8310
Mailing Address - Fax:
Practice Address - Street 1:128 LEUNING ST
Practice Address - Street 2:
Practice Address - City:S HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07606-1317
Practice Address - Country:US
Practice Address - Phone:212-305-8310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005143156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty