Provider Demographics
NPI:1699168526
Name:VISITING VISION SERVICES
Entity type:Organization
Organization Name:VISITING VISION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAUMOVA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-421-9321
Mailing Address - Street 1:571 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-2363
Mailing Address - Country:US
Mailing Address - Phone:201-421-9321
Mailing Address - Fax:
Practice Address - Street 1:571 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-2363
Practice Address - Country:US
Practice Address - Phone:201-421-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00652600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty