Provider Demographics
NPI:1457530115
Name:OPTYX LLC
Entity Type:Organization
Organization Name:OPTYX LLC
Other - Org Name:GRUENEYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-336-5661
Mailing Address - Street 1:312 SPRINGFIELD AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1277
Mailing Address - Country:US
Mailing Address - Phone:908-336-5661
Mailing Address - Fax:866-384-7716
Practice Address - Street 1:1036 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8111
Practice Address - Country:US
Practice Address - Phone:212-751-6177
Practice Address - Fax:212-759-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4948450009Medicare PIN