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NPI Code Detail

MEDICARE: EMPIRE VISION CENTER INC

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 License Number License Number State
1152W00000XOptometrist
2332H00000XEyewear Supplier
3156F00000XTechnician/Technologist

General Provider Information

NPI Number : 1841253614
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPIRE VISION CENTER INC
Provider Business Mailing Address
First Line : 159 EXPRESS STREET
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 : 6660 4TH SECTION RD
Second Line : SUITE 3
City : BROCKPORT
State : NY
Zip : 14420-2448
Country : US
Telephone Number : 585-637-3300
Fax Number : 585-637-3439
Authorized Official
Title or Position : SVP
Name : MR. THOMAS J ROSA
Credential :
Telephone Number : 315-445-7466
Provider Enumeration Date : 04/11/2006
Last Update Date : 06/23/2011

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