Healthcare Provider Details

I. General information

NPI: 1689192551
Provider Name (Legal Business Name): SOUNDVIEW OPTOMETRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ROUTE 25A STE F
SHOREHAM NY
11786-1389
US

IV. Provider business mailing address

45 ROUTE 25A STE F
SHOREHAM NY
11786-1389
US

V. Phone/Fax

Practice location:
  • Phone: 631-821-2244
  • Fax: 631-821-4228
Mailing address:
  • Phone: 631-821-2244
  • Fax: 631-821-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV004145
License Number StateNY

VIII. Authorized Official

Name: DR. JEFFREY KRAUSHAAR
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 631-821-2244