Healthcare Provider Details

I. General information

NPI: 1942291273
Provider Name (Legal Business Name): NATIONAL VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 FLATBUSH AVE
BROOKLYN NY
11226-3102
US

IV. Provider business mailing address

820 FLATBUSH AVE
BROOKLYN NY
11226-3102
US

V. Phone/Fax

Practice location:
  • Phone: 718-693-5994
  • Fax: 718-693-6284
Mailing address:
  • Phone: 718-693-5994
  • Fax: 718-693-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ADOLPHUS CHUKWUGOZIE ANOSIKE
Title or Position: PRESIDENT
Credential: OD
Phone: 718-693-5994