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General NPI Number Information
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NPI Number | 1497605794
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Entity Type | Organization
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Legal Business Name | EMERGING VISION
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 27 ROCKLAND CTR
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City | NANUET
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State | NY
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Zip | 10954-2965
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Country | US
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Telephone | 845-623-8974
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Fax |
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Provider Business Mailing Address
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Address Line | 100 QUENTIN ROOSEVELT BLVD STE 101
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City | GARDEN CITY
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State | NY
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Zip | 11530-4843
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Country | US
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Telephone | 858-414-3513
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Fax |
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Authorized Official
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Title or Position | CREDENTIAL OFFICER
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Name | NICHOLAS SHASHATI
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Credential |
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Telephone | 858-414-3513
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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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