1366403115 NPI number — GENERAL VISION SERVICES

Table of content: (NPI 1366403115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366403115 NPI number — GENERAL VISION SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENERAL VISION SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366403115
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 8TH AVE
Provider Second Line Business Mailing Address:
9TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-6507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-729-5300
Provider Business Mailing Address Fax Number:
212-729-5382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 8TH AVE
Provider Second Line Business Practice Location Address:
9TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10018-6507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-729-5300
Provider Business Practice Location Address Fax Number:
212-729-5382
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CETTINA
Authorized Official First Name:
DARLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
212-729-5300

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  002927 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 001885 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 002134 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: 002789 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003320 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003347 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003362 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003417 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003545 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003573 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 003685 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 004062 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 004782 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 005062 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 005186 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02321039 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324972 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0231108 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02321084 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324812 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02325088 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02320932 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324849 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02320905 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02325111 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02320643 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324909 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02409281 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02320950 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324990 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02320914 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324936 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02324954 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02320818 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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