Provider Demographics
NPI:1932249083
Name:IZE OPTIC INC
Entity Type:Organization
Organization Name:IZE OPTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PORSHAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-948-9682
Mailing Address - Street 1:59 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2611
Mailing Address - Country:US
Mailing Address - Phone:718-948-9088
Mailing Address - Fax:
Practice Address - Street 1:59 PAGE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2611
Practice Address - Country:US
Practice Address - Phone:718-948-9088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007028156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty