Provider Demographics
NPI:1518179621
Name:SOL OPTICAL LLC
Entity Type:Organization
Organization Name:SOL OPTICAL LLC
Other - Org Name:LEON BEER OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-853-7203
Mailing Address - Street 1:4410 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1201
Mailing Address - Country:US
Mailing Address - Phone:718-853-7203
Mailing Address - Fax:718-431-1411
Practice Address - Street 1:4410 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1201
Practice Address - Country:US
Practice Address - Phone:718-853-7203
Practice Address - Fax:718-431-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003949152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC49841Medicare ID - Type Unspecified
NY4651440001Medicare NSC
NYCAWEC1Medicare PIN