1477635142 NPI number — WASHINGTON HEIGHTS OPTICAL INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477635142 NPI number — WASHINGTON HEIGHTS OPTICAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON HEIGHTS OPTICAL INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477635142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 BIRDIE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTEBELLO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10901-3940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-357-3284
Provider Business Mailing Address Fax Number:
212-569-9100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4211 BROADWAY
Provider Second Line Business Practice Location Address:
GEORGE WASHINGTON BRIDGE BUS STATION
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10033-3747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-928-9590
Provider Business Practice Location Address Fax Number:
212-569-9100
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ORMSBY
Authorized Official First Name:
NORICE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-928-9590

Provider Taxonomy Codes

  • Taxonomy code: 156FX1202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01926172 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 333512 . This is a "NVA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CT2804 . This is a "EYE MED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 40574 . This is a "DAVIS VISION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 12852 . This is a "SPECTERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 59C0181 . This is a "COMMUNITY PREMIER PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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