Provider Demographics
NPI:1194616813
Name:GLASSES GUY 18INC
Entity type:Organization
Organization Name:GLASSES GUY 18INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAHAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-341-0485
Mailing Address - Street 1:78 ROCKAWAY AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5809
Mailing Address - Country:US
Mailing Address - Phone:516-341-0485
Mailing Address - Fax:
Practice Address - Street 1:78 ROCKAWAY AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5809
Practice Address - Country:US
Practice Address - Phone:516-341-0485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty