Organization
NORTHEAST SPEC CORP
Active
Other names
Northern Eyes
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY LEE HARBECK OD (PRESIDENT OD)
(518) 587-0258
Entity
Organization
Contact information
Practice address
16 OLD GICK RD, WILTON, NY 12866
(518) 587-0258
(518) 583-3991
Mailing address
PO BOX 496, DELMAR, NY 12054
(518) 587-0258
(518) 583-3991
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T003818
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000845
CDPHP
—
01
—
41360
SPECTEA
—
01
—
420
DAVIS
—
01
—
5252
MVP
—
01
—
C2811
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/19/2006
Last updated
08/22/2020
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