Provider Demographics
NPI:1336414242
Name:WIZE EYES V
Entity Type:Organization
Organization Name:WIZE EYES V
Other - Org Name:WIZE EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SFERLAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-797-3999
Mailing Address - Street 1:4222 SUNRISE HWY UNIT A
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5340
Mailing Address - Country:US
Mailing Address - Phone:516-797-3999
Mailing Address - Fax:516-797-3555
Practice Address - Street 1:4222 SUNRISE HWY UNIT A
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5340
Practice Address - Country:US
Practice Address - Phone:516-797-3999
Practice Address - Fax:516-797-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier