Provider Demographics
NPI:1285092551
Name:CLEAR SIGHT OPTICAL CORP.
Entity type:Organization
Organization Name:CLEAR SIGHT OPTICAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVILENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-477-6700
Mailing Address - Street 1:2791 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5882
Mailing Address - Country:US
Mailing Address - Phone:718-494-9257
Mailing Address - Fax:718-494-4183
Practice Address - Street 1:2791 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5882
Practice Address - Country:US
Practice Address - Phone:718-494-9257
Practice Address - Fax:718-494-4183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty