Provider Demographics
NPI:1891035069
Name:OPTICS BY MDB INC
Entity Type:Organization
Organization Name:OPTICS BY MDB INC
Other - Org Name:TRAPP OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLAK HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETREIST
Authorized Official - Phone:914-967-5565
Mailing Address - Street 1:14 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3003
Mailing Address - Country:US
Mailing Address - Phone:914-967-5565
Mailing Address - Fax:914-967-5814
Practice Address - Street 1:14 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3003
Practice Address - Country:US
Practice Address - Phone:914-967-5565
Practice Address - Fax:914-967-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005933-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1508005893OtherOPTOMETRISTS