Provider Demographics
NPI:1770140816
Name:OPTICAL SHOP OF NEW HOPE INC.
Entity type:Organization
Organization Name:OPTICAL SHOP OF NEW HOPE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PLISETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:267-740-7972
Mailing Address - Street 1:102 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-2200
Mailing Address - Country:US
Mailing Address - Phone:267-740-7972
Mailing Address - Fax:
Practice Address - Street 1:102 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-2200
Practice Address - Country:US
Practice Address - Phone:267-740-7972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty