MEDICARE: VISION QUEST OF 86 ST

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	156F00000X	Technician/Technologist

General Provider Information

NPI Number	:	1588716377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION QUEST OF 86 ST

Provider Business Mailing Address
First Line	:	3073 STEINWAY ST
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11103-3801
Country	:	US
Telephone Number	:	718-626-5184
Fax Number	:	718-626-5405

Provider Business Practice Location Address
First Line	:	482 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4708
Country	:	US
Telephone Number	:	718-921-5488
Fax Number	:

Authorized Official
Title or Position	:	MQANAGER
Name	:	SHERI SMITH
Credential	:
Telephone Number	:	718-626-5184

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/22/2020

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Directions to “VISION QUEST OF 86 ST ” Practice Location

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