Provider Demographics
NPI:1265508220
Name:GENERAL VISION SERVICES LLC
Entity Type:Organization
Organization Name:GENERAL VISION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:SRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-729-5365
Mailing Address - Street 1:520 8TH AVE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6507
Mailing Address - Country:US
Mailing Address - Phone:212-729-5300
Mailing Address - Fax:212-967-4781
Practice Address - Street 1:167 W 72ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3221
Practice Address - Country:US
Practice Address - Phone:212-362-4110
Practice Address - Fax:212-362-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTIN