Provider Demographics
NPI:1881661064
Name:OPTINESS INC
Entity Type:Organization
Organization Name:OPTINESS INC
Other - Org Name:VISUAL ASPECTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST PRES OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-239-8932
Mailing Address - Street 1:575 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11096-1300
Mailing Address - Country:US
Mailing Address - Phone:516-239-8932
Mailing Address - Fax:516-239-5121
Practice Address - Street 1:575 BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:NY
Practice Address - Zip Code:11096-1300
Practice Address - Country:US
Practice Address - Phone:516-239-8932
Practice Address - Fax:516-239-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003677332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00661078Medicaid
NY00661078Medicaid