Provider Demographics
NPI:1356583967
Name:ANALAB OPTOMETRY PC
Entity type:Organization
Organization Name:ANALAB OPTOMETRY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-227-6737
Mailing Address - Street 1:822 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-7373
Mailing Address - Country:US
Mailing Address - Phone:845-227-6737
Mailing Address - Fax:845-227-6751
Practice Address - Street 1:822 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-7373
Practice Address - Country:US
Practice Address - Phone:845-227-6737
Practice Address - Fax:845-227-6751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005552-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02271887Medicaid