Healthcare Provider Details

I. General information

NPI: 1154249589
Provider Name (Legal Business Name): NORWAY AVENUE OPTOMETRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 JAY ST
BROOKLYN NY
11201-5164
US

IV. Provider business mailing address

2279 NORWAY AVE 2 FLOORE
STATEN ISLAND NY
10305-3524
US

V. Phone/Fax

Practice location:
  • Phone: 917-930-4344
  • Fax:
Mailing address:
  • Phone: 917-930-4344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: KATSIARYNA KAVALCHUK
Title or Position: OD
Credential:
Phone: 917-930-4344