Healthcare Provider Details

I. General information

NPI: 1750053450
Provider Name (Legal Business Name): SNS VISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 HADDON AVE
WEST BERLIN NJ
08091-1607
US

IV. Provider business mailing address

204 HADDON AVE
WEST BERLIN NJ
08091-1607
US

V. Phone/Fax

Practice location:
  • Phone: 856-768-2515
  • Fax:
Mailing address:
  • Phone: 856-768-2515
  • Fax: 856-768-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SARA SHISSIAS
Title or Position: OPTOMETRIST
Credential: OD
Phone: 917-520-3092