Provider Demographics
NPI:1881773505
Name:OPTICARE INC.
Entity type:Organization
Organization Name:OPTICARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-775-7595
Mailing Address - Street 1:38 FLOWER LANE
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753
Mailing Address - Country:US
Mailing Address - Phone:516-775-7595
Mailing Address - Fax:516-775-7069
Practice Address - Street 1:1915 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:516-775-7595
Practice Address - Fax:516-775-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004288152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100046754Medicare PIN
NYC43371Medicare PIN
T92819Medicare UPIN