MEDICARE: NW VISION EXPRESS 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
1	152W00000X	Optometrist	TUV005254-1	NY

General Provider Information

NPI Number	:	1992801120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NW VISION EXPRESS INC.

Provider Business Mailing Address
First Line	:	620 W 181ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-4912
Country	:	US
Telephone Number	:	212-795-7780
Fax Number	:	212-927-8600

Provider Business Practice Location Address
First Line	:	620 W 181ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-4912
Country	:	US
Telephone Number	:	212-795-7780
Fax Number	:	212-927-8600

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. SHARI LYNN HAUSMAN
Credential	:	OD
Telephone Number	:	212-795-7780

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/22/2020

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Directions to “NW VISION EXPRESS INC. ” Practice Location

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