Provider Demographics
NPI:1891136552
Name:HARMON OPTICAL CORP.
Entity Type:Organization
Organization Name:HARMON OPTICAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-888-4100
Mailing Address - Street 1:205 E 64TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6635
Mailing Address - Country:US
Mailing Address - Phone:212-888-4100
Mailing Address - Fax:212-888-4111
Practice Address - Street 1:205 E 64TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6635
Practice Address - Country:US
Practice Address - Phone:212-888-4100
Practice Address - Fax:212-888-4111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARMON OPHTHALMOLOGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155183332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01144641Medicaid
NYA64777Medicare UPIN