MEDICARE: EMPIRE VISION CENTER, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	152W00000X	Optometrist
2	332H00000X	Eyewear Supplier
3	156F00000X	Technician/Technologist

General Provider Information

NPI Number	:	1699974642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPIRE VISION CENTER, INC

Provider Business Mailing Address
First Line	:	159 EXPRESS ST
Second Line	:	DAVIS VISION
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-2404
Country	:	US
Telephone Number	:	516-827-6727
Fax Number	:	516-733-5508

Provider Business Practice Location Address
First Line	:	8511 126TH ST
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-3312
Country	:	US
Telephone Number	:	718-849-7773
Fax Number	:	718-849-7780

Authorized Official
Title or Position	:	MANAGER
Name	:	DOLSIE MCDONALD
Credential	:
Telephone Number	:	726-444-4078

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	10/17/2024

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