Provider Demographics
NPI:1891810545
Name:OCEAN OPTICAL, INC.
Entity Type:Organization
Organization Name:OCEAN OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:APARO
Authorized Official - Suffix:
Authorized Official - Credentials:RDO, NCLC
Authorized Official - Phone:978-282-1923
Mailing Address - Street 1:127 EASTERN AVENUE
Mailing Address - Street 2:CAPE ANN MARKET PLACE
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930
Mailing Address - Country:US
Mailing Address - Phone:978-282-1923
Mailing Address - Fax:978-281-5584
Practice Address - Street 1:127 EASTERN AVE
Practice Address - Street 2:CAPE ANN MARKET PLACE
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-1802
Practice Address - Country:US
Practice Address - Phone:978-282-1923
Practice Address - Fax:978-281-5584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2006156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0933970001Medicare NSC