Provider Demographics
NPI:1255438065
Name:OPTECH INC
Entity type:Organization
Organization Name:OPTECH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED OPTICIAN
Authorized Official - Phone:203-966-3492
Mailing Address - Street 1:127 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-5507
Mailing Address - Country:US
Mailing Address - Phone:203-966-0336
Mailing Address - Fax:203-966-7969
Practice Address - Street 1:127 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-5507
Practice Address - Country:US
Practice Address - Phone:203-966-0336
Practice Address - Fax:203-966-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001194332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0168800001Medicare NSC