Provider Demographics
NPI:1235331307
Name:SANGHA OPTICAL INC.
Entity type:Organization
Organization Name:SANGHA OPTICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANHOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-845-6888
Mailing Address - Street 1:12714 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2216
Mailing Address - Country:US
Mailing Address - Phone:718-845-6888
Mailing Address - Fax:718-845-9708
Practice Address - Street 1:12714 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2216
Practice Address - Country:US
Practice Address - Phone:718-845-6888
Practice Address - Fax:718-845-9708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01730309Medicaid
NY1143320001Medicare ID - Type Unspecified