Healthcare Provider Details

I. General information

NPI: 1982267977
Provider Name (Legal Business Name): MONROE VISIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PRESHBURG BLVD UNIT 1
MONROE NY
10950-3066
US

IV. Provider business mailing address

236 BROADWAY STE 211
BROOKLYN NY
11211-8415
US

V. Phone/Fax

Practice location:
  • Phone: 845-782-3332
  • Fax:
Mailing address:
  • Phone: 718-633-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DAVID FREUND
Title or Position: OWNER
Credential:
Phone: 718-522-3332