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General NPI Number Information
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NPI Number | 1104889625
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Entity Type | Organization
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Legal Business Name | EMPIRE VISION CENTER INC
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3401 HARTZDALE DR TOTAL VISION CARE
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City | CAMP HILL
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State | PA
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Zip | 17011
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Country | US
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Telephone | 717-975-0501
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Fax | 717-975-0588
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Provider Business Mailing Address
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Address Line | 2921 ERIE BLVD E
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City | SYRACUSE
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State | NY
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Zip | 13224
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Country | US
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Telephone | 315-446-3145
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Fax | 315-445-7675
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Authorized Official
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Title or Position | VP MANAGED VISION CARE
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Name | DOROTHY REYNOLDS
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Credential |
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Telephone | 726-444-4056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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