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NPI Code Detail

MEDICARE: ENVISION CARE CENTER INC

MEDICARE: ENVISION CARE 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
1152W00000XOptometrist
2152WV0400XVision Therapy Optometrist
3207W00000XOphthalmology Physician
4261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1477812295
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENVISION CARE CENTER INC
Provider Business Mailing Address
First Line : 694 MYRTLE AVE # 506
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-3916
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 505 FLUSHING AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-1610
Country : US
Telephone Number : 718-222-5999
Fax Number :
Authorized Official
Title or Position : TREASURER
Name : JOEL BRAVER
Credential :
Telephone Number : 718-222-5999
Provider Enumeration Date : 05/14/2012
Last Update Date : 05/14/2012

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