Provider Type Icon

OPTICAL SHOP OF DEER PARK INC NPI 1386101632


NPI Information

NPI: 1386101632
Provider Name: OPTICAL SHOP OF DEER PARK INC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
415 COMMACK RD STE 2B
DEER PARK, NY
ZIP 11729
Phone: (631) 392-0711
Get Directions

OPTICAL SHOP OF DEER PARK INC is an eyewear supplier in Deer Park, NY. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. OPTICAL SHOP OF DEER PARK INC NPI is 1386101632. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

415 COMMACK RD STE 2B
DEER PARK, NY
ZIP 11729-508
Phone: (631) 392-0711
Fax: (631) 392-0752

The provider's authorized official is Leonid Gladstein .
The authorized official title is Owner and has the following contact phone number (917) 887-8872.

The enumeration date for this NPI number is 2/22/2019 and was last updated on 7/2/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristNo
2332H00000XEyewear SupplierYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.