Provider Demographics
NPI:1528487410
Name:KLEIN, VICTOR R
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:R
Last Name:KLEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 AUSTIN ST
Mailing Address - Street 2:AMERICAN VISION CARE
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4729
Mailing Address - Country:US
Mailing Address - Phone:718-793-1200
Mailing Address - Fax:
Practice Address - Street 1:7051 AUSTIN ST
Practice Address - Street 2:AMERICAN VISION CARE
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4729
Practice Address - Country:US
Practice Address - Phone:718-793-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004173156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician