Provider Demographics
NPI:1629115480
Name:M.H. OPTICAL INC.
Entity Type:Organization
Organization Name:M.H. OPTICAL INC.
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-567-3500
Mailing Address - Street 1:4800 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-4609
Mailing Address - Country:US
Mailing Address - Phone:631-567-3500
Mailing Address - Fax:631-567-0074
Practice Address - Street 1:4800 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-4609
Practice Address - Country:US
Practice Address - Phone:631-567-3500
Practice Address - Fax:631-567-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYOP0581OtherEYEMED CLAIM NUMBER
NY0846550001Medicare ID - Type UnspecifiedMEDICARE I.D. NUMBER