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Organization

SLATE BELT OPTICAL, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN S BAYDA (OFFICE MANAGER)
(610) 588-5665
Entity
Organization

Contact information

Practice address
352 BLUE VALLEY DR, BANGOR, PA 18013-1515
(610) 588-5665
(610) 588-3383
Mailing address
352 BLUE VALLEY DR, BANGOR, PA 18013-1515
(610) 588-5665
(610) 588-3383

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
156FC0800X
Contact Lens Technician/Technologist
156FX1101X
Ophthalmic Assistant
156FX1201X
Optometric Assistant Technician
156FX1800X
Optician
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
01/22/2013
Last updated
01/22/2013
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