Provider Demographics
NPI:1851467955
Name:MT. SINAI OPTICAL
Entity Type:Organization
Organization Name:MT. SINAI OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:631-474-1616
Mailing Address - Street 1:5507 NESCONSET HWY
Mailing Address - Street 2:SUITE 24
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2031
Mailing Address - Country:US
Mailing Address - Phone:631-474-1616
Mailing Address - Fax:631-474-2092
Practice Address - Street 1:5507 NESCONSET HWY
Practice Address - Street 2:SUITE 24
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2031
Practice Address - Country:US
Practice Address - Phone:631-474-1616
Practice Address - Fax:631-474-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005594-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty