Healthcare Provider Details

I. General information

NPI: 1639470966
Provider Name (Legal Business Name): LENS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 NEW UTRECHT AVE
BROOKLYN NY
11219-4630
US

IV. Provider business mailing address

5511 NEW UTRECHT AVE
BROOKLYN NY
11219-4630
US

V. Phone/Fax

Practice location:
  • Phone: 718-437-8772
  • Fax: 347-230-5992
Mailing address:
  • Phone: 718-437-8772
  • Fax: 347-378-2734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SHEA GOLDBERGER
Title or Position: PRESIDENT
Credential:
Phone: 718-437-8772