Provider Demographics
NPI:1043485360
Name:VALLEY VISION CORP
Entity Type:Organization
Organization Name:VALLEY VISION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARAK
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-887-3831
Mailing Address - Street 1:41 GREEN ACRES ROAD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581
Mailing Address - Country:US
Mailing Address - Phone:516-887-3831
Mailing Address - Fax:516-872-8656
Practice Address - Street 1:41 GREEN ACRES RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1008
Practice Address - Country:US
Practice Address - Phone:516-887-3831
Practice Address - Fax:516-872-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No332H00000XSuppliersEyewear Supplier