Healthcare Provider Details

I. General information

NPI: 1770253296
Provider Name (Legal Business Name): LE VUE OPTICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 HAMMOND PL
WILMINGTON DE
19808-4209
US

IV. Provider business mailing address

2426 HAMMOND PL
WILMINGTON DE
19808-4209
US

V. Phone/Fax

Practice location:
  • Phone: 302-483-7522
  • Fax:
Mailing address:
  • Phone: 302-483-7522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: ELVIA TAPIA VIVAR
Title or Position: PARTNER
Credential:
Phone: 302-442-3027