Provider Demographics
NPI:1659525392
Name:L & R OPTICAL, INC
Entity Type:Organization
Organization Name:L & R OPTICAL, INC
Other - Org Name:PEARLE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-462-1188
Mailing Address - Street 1:6401 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2832
Mailing Address - Country:US
Mailing Address - Phone:631-462-1188
Mailing Address - Fax:631-462-5127
Practice Address - Street 1:6401 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2832
Practice Address - Country:US
Practice Address - Phone:631-462-1188
Practice Address - Fax:631-462-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty