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General NPI Number Information
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NPI Number | 1326002957
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Entity Type | Organization
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Legal Business Name | FAMILY VISION CARE OF KINGSTON, INC.
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 390 PIERCE ST
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City | KINGSTON
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State | PA
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Zip | 18704-5532
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Country | US
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Telephone | 570-714-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 390 PIERCE ST
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City | KINGSTON
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State | PA
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Zip | 18704-5532
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Country | US
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Telephone | 570-714-2600
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Fax | 570-714-9790
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARL URBANSKI
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Credential | OD
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Telephone | 570-714-2600
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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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