1548424468 NPI number — VISION ASSOCIATES OF THE FIVE TOWNS, INC.

Table of content: (NPI 1548424468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548424468 NPI number — VISION ASSOCIATES OF THE FIVE TOWNS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISION ASSOCIATES OF THE FIVE TOWNS, INC.
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:
1548424468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
538 CENTRAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDARHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11516-2127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-374-4383
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
538 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDARHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11516-2127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-374-4383
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RAPPAPORT
Authorized Official First Name:
STUART
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
516-374-1010

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  TUV003912-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 146567 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 932421 . This is a "COLE/EYEMED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2487223 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: C30341 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4307973 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0135633 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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