Provider Demographics
NPI:1215077979
Name:KWIK VISION
Entity type:Organization
Organization Name:KWIK VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:KWIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:585-281-0321
Mailing Address - Street 1:340 MIRACLE MILE DR
Mailing Address - Street 2:DBA COHENS FASHION OPTICAL
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5862
Mailing Address - Country:US
Mailing Address - Phone:585-475-0250
Mailing Address - Fax:585-475-1703
Practice Address - Street 1:340 MIRACLE MILE DR
Practice Address - Street 2:DBA COHENS FASHION OPTICAL
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5862
Practice Address - Country:US
Practice Address - Phone:585-475-0250
Practice Address - Fax:585-475-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006383152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP017002559OtherBLUE CHOICE VENDOR PID
NY7978635OtherAETNA
NYP010016383OtherEXCELLUS-BLUE CHOICE HMO
NY123100CSOtherPREFERRED CARE HMO
NYP050016383OtherEXCELLUS-BLUE SHIELD PPO
NYNY6383OtherEYEMED VISION CARE
NYP010016383OtherEXCELLUS-BLUE CHOICE HMO