Provider Demographics
NPI:1689827800
Name:OPTIKA EYES LTD
Entity Type:Organization
Organization Name:OPTIKA EYES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:DEMARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-567-8852
Mailing Address - Street 1:153 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-2503
Mailing Address - Country:US
Mailing Address - Phone:631-567-8852
Mailing Address - Fax:631-563-0953
Practice Address - Street 1:153 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-2503
Practice Address - Country:US
Practice Address - Phone:631-567-8852
Practice Address - Fax:631-563-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT002964-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier