Healthcare Provider Details

I. General information

NPI: 1306066196
Provider Name (Legal Business Name): ADELINA VOLIS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADELINA VOLIS OD

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 KINGS HWY
BROOKLYN NY
11223-2021
US

IV. Provider business mailing address

4064 OCEAN AVE
BROOKLYN NY
11235-3713
US

V. Phone/Fax

Practice location:
  • Phone: 718-627-0303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number005998
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number005998
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: