Bay Street Optical Pavilion

LBN: Sioc@Bay St Optical Pavilion
Bay Street Optical Pavilion is an health care organization with primary practice located at 664 Bay St Optical, Staten Island NY 10304-3829. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Sioc@Bay St Optical Pavilion can be contacted via phone (718) 727-5678, or through Powell Rivers, Carolyn Rosemary via phone (718) 727-5678.

Contact Information

Primary practice address
664 Bay St Optical Staten Island NY 10304-3829
Phone: (718) 727-5678
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Powell Rivers, Carolyn Rosemary Doctor of Optometry (OD)
Phone: (718) 727-5678

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TUV004813-1 New York

Profile Details

NPI number 1154594190
LBN Legal business name Sioc@Bay St Optical Pavilion
DBA Doing business as Bay Street Optical Pavilion
Authorized official Powell Rivers, Carolyn Rosemary Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2008
Last updated Apr 10th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154594190 NPPES
New York MEDICAID 01065163

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