Provider Demographics
NPI:1265618367
Name:EISS OPTICAL,INC
Entity type:Organization
Organization Name:EISS OPTICAL,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:
Authorized Official - Last Name:EISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-209-1435
Mailing Address - Street 1:6175 STRICKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6409
Mailing Address - Country:US
Mailing Address - Phone:718-209-1435
Mailing Address - Fax:718-968-1448
Practice Address - Street 1:6175 STRICKLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6409
Practice Address - Country:US
Practice Address - Phone:718-209-1435
Practice Address - Fax:718-968-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY4214156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0860780001Medicare NSC