Healthcare Provider Details

I. General information

NPI: 1235382417
Provider Name (Legal Business Name): ASSOCIATION FOR VISION REHABILITATION AND EMPLOYMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 COURT ST
BINGHAMTON NY
13901-3514
US

IV. Provider business mailing address

174 COURT ST
BINGHAMTON NY
13901-3514
US

V. Phone/Fax

Practice location:
  • Phone: 607-724-2428
  • Fax: 607-771-8045
Mailing address:
  • Phone: 607-724-2428
  • Fax: 607-771-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number11837
License Number StateNY

VIII. Authorized Official

Name: MR. ROBERT K. HANYE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 607-724-2428