Healthcare Provider Details

I. General information

NPI: 1750358826
Provider Name (Legal Business Name): EMPIRE VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 ERIE BLVD E
SYRACUSE NY
13224
US

IV. Provider business mailing address

2921 ERIE BLVD E
SYRACUSE NY
13224
US

V. Phone/Fax

Practice location:
  • Phone: 315-446-3145
  • Fax: 315-445-7665
Mailing address:
  • Phone: 315-446-3145
  • Fax: 315-445-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ALAN K THROWER
Title or Position: SVP
Credential:
Phone: 315-446-3145