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General NPI Number Information
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NPI Number | 1487959896
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Entity Type | Organization
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Legal Business Name | VAUGHN VISION LLC
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 170 S BROADWAY
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-4555
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Country | US
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Telephone | 518-306-5290
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Fax | 518-306-5291
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Provider Business Mailing Address
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Address Line | 170 S BROADWAY
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-4555
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Country | US
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Telephone | 518-306-5290
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Fax | 518-306-5291
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHAD A VAUGHN
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Credential | O.D.
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Telephone | 518-944-1800
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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 | TUV006630
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License Number State | NY
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