Provider Demographics
NPI:1134752553
Name:LINA NI OPTOMETRY PLLC
Entity type:Organization
Organization Name:LINA NI OPTOMETRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-686-6294
Mailing Address - Street 1:1 SCHOOL ST UNIT 103
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2529
Mailing Address - Country:US
Mailing Address - Phone:516-686-6294
Mailing Address - Fax:516-686-6294
Practice Address - Street 1:1 SCHOOL ST UNIT 103
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2529
Practice Address - Country:US
Practice Address - Phone:516-686-6294
Practice Address - Fax:516-686-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty