Provider Demographics
NPI:1619135779
Name:OYSTER BAY OPTICS
Entity Type:Organization
Organization Name:OYSTER BAY OPTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-922-0640
Mailing Address - Street 1:101 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2213
Mailing Address - Country:US
Mailing Address - Phone:516-922-0640
Mailing Address - Fax:516-922-1884
Practice Address - Street 1:101 SOUTH ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2213
Practice Address - Country:US
Practice Address - Phone:516-922-0640
Practice Address - Fax:516-922-1884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005523332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier