Provider Demographics
NPI:1518669571
Name:PEAK OPTICIANS LLC
Entity Type:Organization
Organization Name:PEAK OPTICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIANS
Authorized Official - Prefix:
Authorized Official - First Name:SOPHEAK
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-494-4799
Mailing Address - Street 1:174 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4146
Mailing Address - Country:US
Mailing Address - Phone:203-793-7948
Mailing Address - Fax:203-678-4156
Practice Address - Street 1:174 CENTER ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-4146
Practice Address - Country:US
Practice Address - Phone:203-793-7948
Practice Address - Fax:203-678-4156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact LensGroup - Multi-Specialty