Provider Demographics
NPI:1548449788
Name:LUCIEN EYES INC
Entity type:Organization
Organization Name:LUCIEN EYES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DENEVE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:631-286-4014
Mailing Address - Street 1:5 BELLPORT LN
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2705
Mailing Address - Country:US
Mailing Address - Phone:631-286-4014
Mailing Address - Fax:631-286-2070
Practice Address - Street 1:5 BELLPORT LN
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-2705
Practice Address - Country:US
Practice Address - Phone:631-286-4014
Practice Address - Fax:631-286-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006097TUV152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY157939OtherVYTRA
NYNY6097OtherEYE MED
NY7182561OtherAETNA
NY864OtherVISION SCREENING
NY163OtherDAVIS CSEA
NY1497OtherGVS
NY0547081490000OtherCIGNA
NY66599326OtherGHI
NY50593OtherDAVIS
NY50593OtherDAVIS