Provider Demographics
NPI:1316596315
Name:ENVISION EYE CARE INC
Entity Type:Organization
Organization Name:ENVISION EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FAZALUDDIN
Authorized Official - Middle Name:SYED
Authorized Official - Last Name:HASHMI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-702-3981
Mailing Address - Street 1:67 WESTLEY RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3506
Mailing Address - Country:US
Mailing Address - Phone:718-702-3981
Mailing Address - Fax:
Practice Address - Street 1:126 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090
Practice Address - Country:US
Practice Address - Phone:718-702-3981
Practice Address - Fax:908-935-0819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty