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General NPI Number Information
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NPI Number | 1477812295
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Entity Type | Organization
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Legal Business Name | ENVISION CARE CENTER INC
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 05/14/2012
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Provider Practice Location Address
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Address Line | 505 FLUSHING AVE
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City | BROOKLYN
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State | NY
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Zip | 11205-1610
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Country | US
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Telephone | 718-222-5999
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Fax |
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Provider Business Mailing Address
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Address Line | 694 MYRTLE AVE # 506
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City | BROOKLYN
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State | NY
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Zip | 11205-3916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | JOEL BRAVER
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Credential |
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Telephone | 718-222-5999
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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 | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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