Provider Demographics
NPI:1841516408
Name:N & A OPTICAL, INC.
Entity type:Organization
Organization Name:N & A OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NINORKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-464-2020
Mailing Address - Street 1:20504 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2218
Mailing Address - Country:US
Mailing Address - Phone:718-464-2020
Mailing Address - Fax:718-464-2030
Practice Address - Street 1:20504 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2218
Practice Address - Country:US
Practice Address - Phone:718-464-2020
Practice Address - Fax:718-464-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6367780001Medicare NSC