Provider Demographics
NPI:1336531995
Name:Z OPTICAL
Entity type:Organization
Organization Name:Z OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PLISETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-667-8800
Mailing Address - Street 1:287 NEW DORP LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3005
Mailing Address - Country:US
Mailing Address - Phone:718-667-8800
Mailing Address - Fax:
Practice Address - Street 1:278 NEW DORP LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3048
Practice Address - Country:US
Practice Address - Phone:718-667-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty