Healthcare Provider Details

I. General information

NPI: 1093033763
Provider Name (Legal Business Name): VISION WORLD OF JAMAICA AVEINC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16803 JAMAICA AVE
JAMAICA NY
11432-5215
US

IV. Provider business mailing address

16803 JAMAICA AVE
JAMAICA NY
11432-5215
US

V. Phone/Fax

Practice location:
  • Phone: 718-657-4170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS INGA ZHUBRAK
Title or Position: PRESIDENT
Credential:
Phone: 718-657-4170