Provider Demographics
NPI:1972388387
Name:VISION PARTNERS OF WISCONSIN LLC
Entity type:Organization
Organization Name:VISION PARTNERS OF WISCONSIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:MAGYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-393-2020
Mailing Address - Street 1:18200 W CAPITOL DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-1445
Mailing Address - Country:US
Mailing Address - Phone:262-393-2020
Mailing Address - Fax:
Practice Address - Street 1:18200 W CAPITOL DR STE 103
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-1445
Practice Address - Country:US
Practice Address - Phone:262-393-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-25
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty