Provider Demographics
NPI:1619317245
Name:BAY OPTICAL, INC
Entity Type:Organization
Organization Name:BAY OPTICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEAULIEU
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:518-792-1300
Mailing Address - Street 1:3695 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12885-1832
Mailing Address - Country:US
Mailing Address - Phone:518-623-2229
Mailing Address - Fax:518-623-5087
Practice Address - Street 1:3695 MAIN ST
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:NY
Practice Address - Zip Code:12885-1832
Practice Address - Country:US
Practice Address - Phone:518-623-2229
Practice Address - Fax:518-623-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0042381156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty