Healthcare Provider Details

I. General information

NPI: 1144651688
Provider Name (Legal Business Name): NEW YORK VISION ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MADISON AVE SECOND FLOOR
NEW YORK NY
10016-4325
US

IV. Provider business mailing address

185 MADISON AVENUE SECOND FLOOR
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 212-213-3737
  • Fax: 212-213-3787
Mailing address:
  • Phone: 212-213-3737
  • Fax: 212-213-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number004199
License Number StateNY

VIII. Authorized Official

Name: DR. JAY B STOCKMAN
Title or Position: PRESIDENT
Credential: O.D.
Phone: 212-213-3737