MEDICARE: VISION WORLD OF THE BRONX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1427492685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION WORLD OF THE BRONX

Provider Business Mailing Address
First Line	:	1324 METROPOLITAN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7971
Country	:	US
Telephone Number	:	718-863-3023
Fax Number	:	718-863-3024

Provider Business Practice Location Address
First Line	:	1324 METROPOLITAN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7971
Country	:	US
Telephone Number	:	718-863-3023
Fax Number	:	718-863-3024

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	LAURA VALENTIN
Credential	:
Telephone Number	:	718-863-3023

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	04/18/2013

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Directions to “VISION WORLD OF THE BRONX ” Practice Location

Language	Start Address	Practice Location

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