MEDICARE: OPTIKA EYES LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	T002964-1	NY

General Provider Information

NPI Number	:	1689827800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIKA EYES LTD

Provider Business Mailing Address
First Line	:	153 MAIN ST
Second Line	:
City	:	SAYVILLE
State	:	NY
Zip	:	11782-2503
Country	:	US
Telephone Number	:	631-567-8852
Fax Number	:	631-563-0953

Provider Business Practice Location Address
First Line	:	153 MAIN ST
Second Line	:
City	:	SAYVILLE
State	:	NY
Zip	:	11782-2503
Country	:	US
Telephone Number	:	631-567-8852
Fax Number	:	631-563-0953

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOUGLAS ARTHUR DEMARTINO
Credential	:
Telephone Number	:	631-567-8852

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	10/31/2008

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