Provider Demographics
NPI:1437262714
Name:NEW VISION OPHTHALMOLOGY PC
Entity Type:Organization
Organization Name:NEW VISION OPHTHALMOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PC HOLDER
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:FUTORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-265-9900
Mailing Address - Street 1:PO BOX 462
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577
Mailing Address - Country:US
Mailing Address - Phone:718-265-9900
Mailing Address - Fax:718-265-9219
Practice Address - Street 1:2327 83RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2750
Practice Address - Country:US
Practice Address - Phone:718-265-9900
Practice Address - Fax:718-265-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEK471Medicare PIN