Provider Demographics
NPI:1003872755
Name:EMPIRE VISION CENTER INC
Entity Type:Organization
Organization Name:EMPIRE VISION CENTER INC
Other - Org Name:DAVIS VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:THROWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-445-3145
Mailing Address - Street 1:2921 ERIE BLVD EAST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1430
Mailing Address - Country:US
Mailing Address - Phone:315-446-3145
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:313 MERRICK RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5325
Practice Address - Country:US
Practice Address - Phone:516-536-1031
Practice Address - Fax:516-536-1073
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPIRE VISION CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-21
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0505220094Medicare NSC