Provider Demographics
NPI:1124783840
Name:110 VISION LTD.
Entity type:Organization
Organization Name:110 VISION LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-400-4889
Mailing Address - Street 1:259 WALT WHITMAN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4119
Mailing Address - Country:US
Mailing Address - Phone:631-427-7300
Mailing Address - Fax:
Practice Address - Street 1:259 WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4119
Practice Address - Country:US
Practice Address - Phone:631-427-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier