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NPI Code Detail

MEDICARE: EMPIRE VISION CENTER, INC.

MEDICARE: EMPIRE VISION CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1154782837
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPIRE VISION CENTER, INC.
Provider Business Mailing Address
First Line : PO BOX 418348
Second Line :
City : BOSTON
State : MA
Zip : 02241-8348
Country : US
Telephone Number : 800-340-0129
Fax Number : 210-524-6587
Provider Business Practice Location Address
First Line : 2655 RICHMOND AVE
Second Line : STE 1140
City : STATEN ISLAND
State : NY
Zip : 10314-5821
Country : US
Telephone Number : 718-761-5607
Fax Number : 718-761-5452
Authorized Official
Title or Position : VP, RETAIL MANAGED VISION CARE
Name : MS. DOROTHY REYNOLDS
Credential :
Telephone Number : 210-524-6515
Provider Enumeration Date : 03/09/2016
Last Update Date : 03/09/2016

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Directions to “EMPIRE VISION CENTER, INC. ” Practice Location

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