Provider Demographics
NPI:1528315934
Name:QUALITY CARE OPTICIAN SERVICES, PLLC
Entity type:Organization
Organization Name:QUALITY CARE OPTICIAN SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ZORIANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MANGIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-899-2374
Mailing Address - Street 1:16 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1004
Mailing Address - Country:US
Mailing Address - Phone:518-899-2374
Mailing Address - Fax:518-899-2374
Practice Address - Street 1:16 MILLER RD
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1004
Practice Address - Country:US
Practice Address - Phone:518-899-2374
Practice Address - Fax:518-899-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5267156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty