Provider Demographics
NPI:1861889164
Name:E-Z OPTICAL
Entity type:Organization
Organization Name:E-Z OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OPTICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:BIRCH
Authorized Official - Last Name:REZZUTI
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:603-730-2573
Mailing Address - Street 1:680 WHITE MOUNTAIN HWY
Mailing Address - Street 2:SUITE #3
Mailing Address - City:TAMWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03886-4625
Mailing Address - Country:US
Mailing Address - Phone:603-730-2573
Mailing Address - Fax:877-310-7995
Practice Address - Street 1:680 WHITE MOUNTAIN HWY
Practice Address - Street 2:STE 3
Practice Address - City:TAMWORTH
Practice Address - State:NH
Practice Address - Zip Code:03886
Practice Address - Country:US
Practice Address - Phone:603-730-2573
Practice Address - Fax:877-310-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1864332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies