Provider Demographics
NPI:1003458415
Name:SUNNY VISION OPTOMETRY PC
Entity Type:Organization
Organization Name:SUNNY VISION OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPELNIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-404-3764
Mailing Address - Street 1:4504 46TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1702
Mailing Address - Country:US
Mailing Address - Phone:718-784-2580
Mailing Address - Fax:718-784-2524
Practice Address - Street 1:4504 46TH ST
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1702
Practice Address - Country:US
Practice Address - Phone:718-784-2580
Practice Address - Fax:718-784-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty