Provider Demographics
NPI:1487826343
Name:PLASTIC LENSES INC.
Entity Type:Organization
Organization Name:PLASTIC LENSES INC.
Other - Org Name:TRU-SITE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:MESTROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-922-0212
Mailing Address - Street 1:1017 CHESTNUT ST.
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4213
Mailing Address - Country:US
Mailing Address - Phone:215-922-0212
Mailing Address - Fax:215-922-6683
Practice Address - Street 1:1017 CHESTNUT ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4213
Practice Address - Country:US
Practice Address - Phone:215-922-0212
Practice Address - Fax:215-922-6683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty