Provider Demographics
NPI:1518360924
Name:SACHEM OPTICS INC
Entity Type:Organization
Organization Name:SACHEM OPTICS INC
Other - Org Name:SACHEM EYE CARE OF PATCHOGUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-231-4086
Mailing Address - Street 1:655 E MONTAUK HWY STE 29
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3154
Mailing Address - Country:US
Mailing Address - Phone:631-576-4499
Mailing Address - Fax:631-576-4253
Practice Address - Street 1:655 E MONTAUK HWY STE 29
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3154
Practice Address - Country:US
Practice Address - Phone:631-576-4499
Practice Address - Fax:631-576-4253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04096402Medicaid
NY04096402Medicaid