Provider Demographics
NPI:1407327976
Name:AVE U VISION CENTER LLC
Entity Type:Organization
Organization Name:AVE U VISION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPELNIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-404-3764
Mailing Address - Street 1:189 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3741
Mailing Address - Country:US
Mailing Address - Phone:718-373-8510
Mailing Address - Fax:718-373-9805
Practice Address - Street 1:189 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3741
Practice Address - Country:US
Practice Address - Phone:718-373-8510
Practice Address - Fax:718-373-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02879716Medicaid