Basic Information
| Provider Information | |||||||||
| NPI: | 1033176748 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMPIRE VISION CENTER INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CAMBRIDGE EYE DOCTORS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2921 ERIE BLVD EAST | ||||||||
| Address2: | EMPIRE VISION CENTER INC | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154463145 | ||||||||
| FaxNumber: | 3154457675 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HIGHLAND AVE | ||||||||
| Address2: | #3B | ||||||||
| City: | MALDEN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813219039 | ||||||||
| FaxNumber: | 7813218611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2006 | ||||||||
| LastUpdateDate: | 04/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | THROWER | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | SVP | ||||||||
| AuthorizedOfficialTelephone: | 3154463145 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EMPIRE VISION CENTER INC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | N | Suppliers | Eyewear Supplier (Equipment, not the service) | 156F00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Technician/Technologist |
No ID Information.