Provider Demographics
NPI:1568795201
Name:KZS2OPTICALINC
Entity Type:Organization
Organization Name:KZS2OPTICALINC
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIKOLAOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SISKOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-968-6600
Mailing Address - Street 1:5570 XAVIER DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1322
Mailing Address - Country:US
Mailing Address - Phone:914-968-6600
Mailing Address - Fax:914-968-6651
Practice Address - Street 1:5570 XAVIER DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1322
Practice Address - Country:US
Practice Address - Phone:914-968-6600
Practice Address - Fax:914-968-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007749-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty