Provider Demographics
NPI:1992189153
Name:EJMVKK ASSOCIATES INC
Entity type:Organization
Organization Name:EJMVKK ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:VINCENTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-749-7027
Mailing Address - Street 1:10222 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-1739
Mailing Address - Country:US
Mailing Address - Phone:718-846-1144
Mailing Address - Fax:347-772-3032
Practice Address - Street 1:10222 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-1739
Practice Address - Country:US
Practice Address - Phone:718-846-1144
Practice Address - Fax:347-772-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007143152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty