Provider Demographics
NPI:1326119256
Name:EHSOC INC
Entity Type:Organization
Organization Name:EHSOC INC
Other - Org Name:EYECARE OF CNY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-455-8933
Mailing Address - Street 1:2901 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-3217
Mailing Address - Country:US
Mailing Address - Phone:315-455-8933
Mailing Address - Fax:315-455-8934
Practice Address - Street 1:2901 COURT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-3217
Practice Address - Country:US
Practice Address - Phone:315-455-8933
Practice Address - Fax:315-455-8934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005365-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1180310002Medicare NSC
NY56480AMedicare PIN