1922136415 NPI number — EMERGING VISION INC

Table of content: (NPI 1922136415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922136415 NPI number — EMERGING VISION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERGING VISION INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
STERLING OPTICAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922136415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 QUENTIN ROOSEVELT BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDEN CITY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11530-4874
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-390-2101
Provider Business Mailing Address Fax Number:
516-390-2110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 CHAMBERS RD
Provider Second Line Business Practice Location Address:
ARNOT MALL BOX 5134
Provider Business Practice Location Address City Name:
HORSEHEADS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14845-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-739-5644
Provider Business Practice Location Address Fax Number:
607-796-0080
Provider Enumeration Date:
02/28/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEWIS
Authorized Official First Name:
MYLES
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
516-390-2101

Provider Taxonomy Codes

  • Taxonomy code: 156FX1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)