Provider Demographics
NPI:1427124221
Name:NEW WORLD VISION CENTER, INC.
Entity type:Organization
Organization Name:NEW WORLD VISION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:TU
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-599-2020
Mailing Address - Street 1:612 WASHINGTON AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-4836
Mailing Address - Country:US
Mailing Address - Phone:215-599-2020
Mailing Address - Fax:215-599-2023
Practice Address - Street 1:612 WASHINGTON AVE UNIT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-4836
Practice Address - Country:US
Practice Address - Phone:215-599-2020
Practice Address - Fax:215-599-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA144073152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022431090001Medicaid
PA1022431090001Medicaid