Provider Demographics
NPI:1851983654
Name:EYE CARE VISION OPTOMETRY P.C.
Entity type:Organization
Organization Name:EYE CARE VISION OPTOMETRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-921-1738
Mailing Address - Street 1:20980 CIPRES WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1604
Mailing Address - Country:US
Mailing Address - Phone:646-921-1738
Mailing Address - Fax:315-612-9793
Practice Address - Street 1:260 CHRISTOPHER LN STE 102A
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1631
Practice Address - Country:US
Practice Address - Phone:646-921-1738
Practice Address - Fax:315-612-9793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty