Basic Information
| Provider Information | |||||||||
| NPI: | 1790195865 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OVERLOOK OPTICAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 BUTTRICK RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LONDONDERRY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030533417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034344193 | ||||||||
| FaxNumber: | 6034376804 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 BUTTRICK RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LONDONDERRY | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030533417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034344193 | ||||||||
| FaxNumber: | 6034376804 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2014 | ||||||||
| LastUpdateDate: | 06/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | SPINDEL | ||||||||
| AuthorizedOfficialFirstName: | GERALD | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6034344193 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 156FC0800X | N | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Technician/Technologist | Contact Lens | 156FX1800X | Y | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Technician/Technologist | Optician |
No ID Information.