Healthcare Provider Details

I. General information

NPI: 1750200176
Provider Name (Legal Business Name): PRAMUKH VISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7630 BROADVIEW RD
PARMA OH
44134-6745
US

IV. Provider business mailing address

7630 BROADVIEW RD
PARMA OH
44134-6745
US

V. Phone/Fax

Practice location:
  • Phone: 216-642-5500
  • Fax:
Mailing address:
  • Phone: 216-642-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: SHARON KERNIG
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 330-235-3156