Provider Demographics
NPI:1649755851
Name:SIGHTRITE MEDICAL MD LLC
Entity Type:Organization
Organization Name:SIGHTRITE MEDICAL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:FINESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-764-0008
Mailing Address - Street 1:236 BROADWAY STE 220
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-8415
Mailing Address - Country:US
Mailing Address - Phone:171-863-3245
Mailing Address - Fax:
Practice Address - Street 1:1300 WINDLASS DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-4126
Practice Address - Country:US
Practice Address - Phone:212-764-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty