Provider Demographics
NPI:1992801120
Name:NW VISION EXPRESS INC.
Entity type:Organization
Organization Name:NW VISION EXPRESS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-795-7780
Mailing Address - Street 1:620 W 181ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4912
Mailing Address - Country:US
Mailing Address - Phone:212-795-7780
Mailing Address - Fax:212-927-8600
Practice Address - Street 1:620 W 181ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4912
Practice Address - Country:US
Practice Address - Phone:212-795-7780
Practice Address - Fax:212-927-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005254-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty