Provider Demographics
NPI:1427492685
Name:VISION WORLD OF THE BRONX
Entity type:Organization
Organization Name:VISION WORLD OF THE BRONX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-863-3023
Mailing Address - Street 1:1324 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7971
Mailing Address - Country:US
Mailing Address - Phone:718-863-3023
Mailing Address - Fax:718-863-3024
Practice Address - Street 1:1324 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7971
Practice Address - Country:US
Practice Address - Phone:718-863-3023
Practice Address - Fax:718-863-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier