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NPI 1376509869

NPI 1376509869 : EMPIRE VISION CENTER INC : NORWICH, NY

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General NPI Number Information
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    NPI Number           |    1376509869
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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     |    04/24/2006
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    Last Update Date     |    06/23/2025
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Provider Practice Location Address
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    Address Line         |    5631 STATE HIGHWAY 12 STE B 
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    City                 |    NORWICH
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    State                |    NY
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    Zip                  |    13815-3205
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    Country              |    US
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    Telephone            |    607-336-2007
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    Fax                  |    607-336-2047
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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    |    MANAGER
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    Name                 |     DOLSIE  MCDONALD 
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    Credential           |    
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    Telephone            |    726-444-4078
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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        |    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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Taxonomy #3
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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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