Provider Demographics
NPI:1477635142
Name:WASHINGTON HEIGHTS OPTICAL INC.
Entity Type:Organization
Organization Name:WASHINGTON HEIGHTS OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-928-9590
Mailing Address - Street 1:8 BIRDIE RD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3940
Mailing Address - Country:US
Mailing Address - Phone:845-357-3284
Mailing Address - Fax:212-569-9100
Practice Address - Street 1:4211 BROADWAY
Practice Address - Street 2:GEORGE WASHINGTON BRIDGE BUS STATION
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3747
Practice Address - Country:US
Practice Address - Phone:212-928-9590
Practice Address - Fax:212-569-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01926172Medicaid
NY333512OtherNVA
NYCT2804OtherEYE MED
NY40574OtherDAVIS VISION
NY12852OtherSPECTERA
NY59C0181OtherCOMMUNITY PREMIER PLUS
NY59C0181OtherCOMMUNITY PREMIER PLUS