Provider Demographics
NPI:1508977687
Name:BRIT OPTICAL INC
Entity Type:Organization
Organization Name:BRIT OPTICAL INC
Other - Org Name:DEPUTY EYEWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:PONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-673-1267
Mailing Address - Street 1:13020 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1651
Mailing Address - Country:US
Mailing Address - Phone:215-673-1267
Mailing Address - Fax:215-676-7085
Practice Address - Street 1:13020 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1651
Practice Address - Country:US
Practice Address - Phone:215-673-1267
Practice Address - Fax:215-676-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOD1321156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1230700001Medicare NSC