Provider Demographics
NPI:1871902577
Name:I2IOPTIQUE
Entity type:Organization
Organization Name:I2IOPTIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASNOV
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:917-686-2749
Mailing Address - Street 1:8320 N HAYDEN RD
Mailing Address - Street 2:#E103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-2474
Mailing Address - Country:US
Mailing Address - Phone:480-767-3450
Mailing Address - Fax:480-767-3305
Practice Address - Street 1:8320 N HAYDEN RD
Practice Address - Street 2:#E103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-2474
Practice Address - Country:US
Practice Address - Phone:480-767-3450
Practice Address - Fax:480-767-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty