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General NPI Number Information
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NPI Number | 1366742991
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Entity Type | Organization
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Legal Business Name | EMERGING VISION, INC
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Dates
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Enumeration Date | 10/29/2010
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 95 N MOORLAND ROAD
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City | BROOKFIELD
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State | WI
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Zip | 53005
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Country | US
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Telephone | 262-786-7120
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Fax | 262-786-6404
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Provider Business Mailing Address
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Address Line | 95 N MOORLAND ROAD
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City | BROOKFIELD
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State | WI
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Zip | 53005
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Country | US
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Telephone | 262-786-7120
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Fax | 262-786-6404
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAM HERSKOWITZ
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Credential |
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Telephone | 646-737-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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