Provider Demographics
NPI:1558585018
Name:OPTIC MASTERS, INC
Entity Type:Organization
Organization Name:OPTIC MASTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:516-364-7474
Mailing Address - Street 1:8025 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1230
Mailing Address - Country:US
Mailing Address - Phone:516-364-7474
Mailing Address - Fax:516-364-7417
Practice Address - Street 1:8025 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1230
Practice Address - Country:US
Practice Address - Phone:516-364-7474
Practice Address - Fax:516-364-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5669152W00000X
NY4001156FX1800X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0165096OtherGHI
NY2468499OtherAETNA HMO
NY2420859OtherUNITED HEALTHCARE
NYP770635OtherOXFORD HEALTH PLANS
NY7499145OtherAETNA PPO
NY0165096OtherGHI
NY2420859OtherUNITED HEALTHCARE
NY5973490001Medicare NSC