Provider Demographics
NPI:1962617340
Name:PIPA'S OPTICAL, PSC
Entity type:Organization
Organization Name:PIPA'S OPTICAL, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIFONTES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-250-9412
Mailing Address - Street 1:PMB 245 PO BOX 70344
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-250-9412
Mailing Address - Fax:787-281-0803
Practice Address - Street 1:EDIFICIO ESTACIONAMIENTO CENTRO MEDICO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-250-9412
Practice Address - Fax:787-281-0803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR411332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier