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General NPI Number Information
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NPI Number | 1316596315
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Entity Type | Organization
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Legal Business Name | ENVISION EYE CARE INC
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 126 CENTRAL AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090
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Country | US
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Telephone | 718-702-3981
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Fax | 908-935-0819
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Provider Business Mailing Address
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Address Line | 67 WESTLEY RD
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-3506
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Country | US
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Telephone | 718-702-3981
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. FAZALUDDIN SYED HASHMI
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Credential | O.D.
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Telephone | 718-702-3981
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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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