=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093464059
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FORESIGHT EYE CARE OPTOMETRY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2022
-----------------------------------------------------
Last Update Date | 07/13/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26 S GREELEY AVE STE 4
-----------------------------------------------------
City | CHAPPAQUA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10514-3332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-241-4868
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 GRAND BLVD
-----------------------------------------------------
City | VALHALLA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10595-1412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-241-4868
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | DR. SAARA HASHMI
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 646-241-4868
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------