Provider Demographics
NPI:1053552661
Name:ON-SIGHT OPTICAL, LLC
Entity type:Organization
Organization Name:ON-SIGHT OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:DANA
Authorized Official - Last Name:JADOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-531-5071
Mailing Address - Street 1:PO BOX 1315
Mailing Address - Street 2:
Mailing Address - City:STANARDSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22973-1315
Mailing Address - Country:US
Mailing Address - Phone:434-531-5071
Mailing Address - Fax:434-990-0126
Practice Address - Street 1:102 MAIN ST
Practice Address - Street 2:
Practice Address - City:STANARDSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22973-2970
Practice Address - Country:US
Practice Address - Phone:434-531-5071
Practice Address - Fax:434-990-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101001285156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty