<Unavail>

LBN: Mammoth Optical
<Unavail> is an health care organization with primary practice located at 2194 Nesconset Hwy Ste A , Stony Brook NY 11790-3500. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Mammoth Optical can be contacted via phone (631) 246-5468, or through Polan, Andrew Neil via phone (631) 246-5468.

Contact Information

Primary practice address
2194 Nesconset Hwy Ste A Stony Brook NY 11790-3500
Phone: (631) 246-5468
Fax: (631) 246-5442
Website:
Map and Directions
Authorized official contact:
Name: Polan, Andrew Neil
Phone: (631) 246-5468

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 6197 New York

Profile Details

NPI number 1487705018
LBN Legal business name Mammoth Optical
DBA Doing business as <Unavail>
Authorized official Polan, Andrew Neil
Entity Organization
Organization subpart 1 No
Enumeration date Jan 12th, 2007
Last updated Aug 22nd, 2020 - about 6 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 1487705018 NPPES
New York MEDICAID 01679698

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