Healthcare Provider Details

I. General information

NPI: 1083741540
Provider Name (Legal Business Name): NEW VISIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 UNIVERSITY AVE SUITE 311
HONOLULU HI
96826-1540
US

IV. Provider business mailing address

1110 UNIVERSITY AVE SUITE 311
HONOLULU HI
96826-1540
US

V. Phone/Fax

Practice location:
  • Phone: 808-528-5252
  • Fax: 808-528-0580
Mailing address:
  • Phone: 808-528-5252
  • Fax: 808-528-0580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number159
License Number StateHI

VIII. Authorized Official

Name: MR. PETER E ACKMAN
Title or Position: OWNER OPTICIAN
Credential: LDO
Phone: 808-528-5252