Provider Demographics
NPI:1407984453
Name:EMERGING VISION INC
Entity Type:Organization
Organization Name:EMERGING VISION INC
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-390-2101
Mailing Address - Street 1:100 QUENTIN ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4874
Mailing Address - Country:US
Mailing Address - Phone:516-390-2101
Mailing Address - Fax:516-390-2110
Practice Address - Street 1:ROUTES 5 AND 5A
Practice Address - Street 2:SANGERTOWN MALL
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1501
Practice Address - Country:US
Practice Address - Phone:315-797-3357
Practice Address - Fax:315-797-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02579220Medicaid