Provider Demographics
NPI:1447319421
Name:OPTICS LTD
Entity type:Organization
Organization Name:OPTICS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYYAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-388-4456
Mailing Address - Street 1:102 RACETRACK ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TICONDEROGA
Mailing Address - State:NY
Mailing Address - Zip Code:12883
Mailing Address - Country:US
Mailing Address - Phone:518-585-4000
Mailing Address - Fax:
Practice Address - Street 1:102 RACE TRACK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:TICONDEROGA
Practice Address - State:NY
Practice Address - Zip Code:12883-4004
Practice Address - Country:US
Practice Address - Phone:518-585-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01074491Medicaid