MEDICARE: BRONX VISION OPTOMETRY AND OPHTHALMIC DISPENSING PLLC

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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1962081968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONX VISION OPTOMETRY AND OPHTHALMIC DISPENSING PLLC

Provider Business Mailing Address
First Line	:	2856 3RD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-2726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2856 3RD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-2726
Country	:	US
Telephone Number	:	718-292-0805
Fax Number	:	718-585-5100

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ARTHUR VAYNER
Credential	:	OD
Telephone Number	:	718-373-2020

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	04/06/2021

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