Healthcare Provider Details

I. General information

NPI: 1821186651
Provider Name (Legal Business Name): VISION FOR LESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4363 WHITE PLAINS RD
BRONX NY
10466-1414
US

IV. Provider business mailing address

4363 WHITE PLAINS RD
BRONX NY
10466-1414
US

V. Phone/Fax

Practice location:
  • Phone: 718-994-2753
  • Fax: 718-994-8753
Mailing address:
  • Phone: 718-994-2753
  • Fax: 718-994-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number0024881
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberTUV005815-1
License Number StateNY

VIII. Authorized Official

Name: MS. FRAZELL BENJAMIN
Title or Position: OWNER
Credential: OPTICIAN
Phone: 718-994-2753