Provider Demographics
NPI:1063537884
Name:HEMPSTEAD OPTICAL INC.
Entity type:Organization
Organization Name:HEMPSTEAD OPTICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-481-2020
Mailing Address - Street 1:112 FULTON AVE
Mailing Address - Street 2:B
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3752
Mailing Address - Country:US
Mailing Address - Phone:516-481-2020
Mailing Address - Fax:516-620-9064
Practice Address - Street 1:112 FULTON AVE
Practice Address - Street 2:B
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3752
Practice Address - Country:US
Practice Address - Phone:516-481-2020
Practice Address - Fax:516-620-9064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIANT OPTICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-20
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005281-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2146206OtherAETNA
NY146056OtherVYTRA
NY37514POtherHIP OF NEW YORK
NYP2077105OtherOXFORD
NY2160672Other2160672
NY4C2296OtherHEALTHNET
NY6500906OtherGHI
NYC47481OtherBLUE CROSS
NY=========OtherUNITED HEATH CARE
NY146056OtherVYTRA
NY=========OtherTHE EMPIRE PLAN
NY=========OtherHEATH CARE PARTERS