Basic Information
| Provider Information | |||||||||
| NPI: | 1427492685 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VISION WORLD OF THE BRONX | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1324 METROPOLITAN AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104627971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188633023 | ||||||||
| FaxNumber: | 7188633024 | ||||||||
| Practice Location | |||||||||
| Address1: | 1324 METROPOLITAN AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104627971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188633023 | ||||||||
| FaxNumber: | 7188633024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2013 | ||||||||
| LastUpdateDate: | 04/18/2013 | ||||||||
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| AuthorizedOfficialLastName: | VALENTIN | ||||||||
| AuthorizedOfficialFirstName: | LAURA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 7188633023 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.