Provider Demographics
NPI:1922194802
Name:POST PLAZA OPTICAL CORPORATION
Entity Type:Organization
Organization Name:POST PLAZA OPTICAL CORPORATION
Other - Org Name:FRAME AND EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PEPA
Authorized Official - Suffix:
Authorized Official - Credentials:OPT
Authorized Official - Phone:631-673-5010
Mailing Address - Street 1:862 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7505
Mailing Address - Country:US
Mailing Address - Phone:631-673-5010
Mailing Address - Fax:631-673-5014
Practice Address - Street 1:862 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7505
Practice Address - Country:US
Practice Address - Phone:631-673-5010
Practice Address - Fax:631-673-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004573332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000379Medicare PIN
NY0848160001Medicare NSC