Provider Demographics
NPI:1447380050
Name:TWILIGHT OPTICAL INC.
Entity Type:Organization
Organization Name:TWILIGHT OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUNDLICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-745-0737
Mailing Address - Street 1:660 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4708
Mailing Address - Country:US
Mailing Address - Phone:516-745-0737
Mailing Address - Fax:516-745-1514
Practice Address - Street 1:660 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4708
Practice Address - Country:US
Practice Address - Phone:516-745-0737
Practice Address - Fax:516-745-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT004122-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100029134Medicare PIN