Provider Demographics
NPI:1104982594
Name:TOWN OPTICAL INC
Entity type:Organization
Organization Name:TOWN OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:B
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF OPTOMETRY
Authorized Official - Phone:212-719-4000
Mailing Address - Street 1:2 W 47TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3319
Mailing Address - Country:US
Mailing Address - Phone:212-719-4000
Mailing Address - Fax:212-382-2123
Practice Address - Street 1:2 W 47TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-3319
Practice Address - Country:US
Practice Address - Phone:212-719-4000
Practice Address - Fax:212-382-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY004271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07386OtherGHI MEDICARE
NYCOW311Medicare PIN
NYT49032Medicare UPIN
NY0262710001Medicare NSC