Provider Demographics
NPI:1942322748
Name:OPTICAL DESIGNS INC
Entity Type:Organization
Organization Name:OPTICAL DESIGNS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDO
Authorized Official - Phone:781-449-4455
Mailing Address - Street 1:1211 HIGHLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2634
Mailing Address - Country:US
Mailing Address - Phone:781-449-4455
Mailing Address - Fax:781-449-0777
Practice Address - Street 1:1211 HIGHLAND AVENUE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2634
Practice Address - Country:US
Practice Address - Phone:781-449-4455
Practice Address - Fax:781-449-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4371156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
800672OtherTUFTS MEDICARE PREFERRED
MA0138230001Medicare NSC