Healthcare Provider Details

I. General information

NPI: 1619936614
Provider Name (Legal Business Name): EMPIRE VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 ARSENAL STREET
WATERTOWN NY
13601-2211
US

IV. Provider business mailing address

2921 ERIE BLVD E
SYRACUSE NY
13224-1430
US

V. Phone/Fax

Practice location:
  • Phone: 315-788-5020
  • Fax: 315-788-5028
Mailing address:
  • Phone: 315-446-3145
  • Fax: 315-445-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

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