Healthcare Provider Details

I. General information

NPI: 1306801345
Provider Name (Legal Business Name): EMPIRE VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 ENDICOTT STREET CAMBRIDGE EYE DOCTORS
DANVERS MA
01923
US

IV. Provider business mailing address

2921 ERIE BLVD EAST EMPIRE VISION CENTER INC
SYRACUSE NY
13224
US

V. Phone/Fax

Practice location:
  • Phone: 978-777-4700
  • Fax: 978-750-0862
Mailing address:
  • Phone: 315-446-3145
  • Fax: 315-445-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ALAN K THROWER
Title or Position: SVP
Credential:
Phone: 315-446-3145