Provider Demographics
NPI:1245883271
Name:PLAZA OPTICAL
Entity type:Organization
Organization Name:PLAZA OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-253-1010
Mailing Address - Street 1:5100 KINGS PLZ
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5208
Mailing Address - Country:US
Mailing Address - Phone:718-253-1010
Mailing Address - Fax:718-377-1090
Practice Address - Street 1:5100 KINGS PLZ
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5208
Practice Address - Country:US
Practice Address - Phone:718-253-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty