Provider Demographics
NPI:1962585307
Name:OPTICAL SOLUTIONS , INC
Entity type:Organization
Organization Name:OPTICAL SOLUTIONS , INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:YUCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-666-8282
Mailing Address - Street 1:627 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8506
Mailing Address - Country:US
Mailing Address - Phone:631-666-8282
Mailing Address - Fax:631-968-2914
Practice Address - Street 1:627 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8506
Practice Address - Country:US
Practice Address - Phone:631-666-8282
Practice Address - Fax:631-968-2914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2010-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2447152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3028OtherOD
NY2447OtherOD
NY02256137Medicaid
NY3812OtherOD
NY2524OtherOD
NY7995OtherOPHTHALMIC DISPENSER
NY3812OtherOD