Provider Demographics
NPI:1508077108
Name:VS OPTICAL
Entity Type:Organization
Organization Name:VS OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SOROKORENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-969-0100
Mailing Address - Street 1:9863 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-2611
Mailing Address - Country:US
Mailing Address - Phone:215-969-0100
Mailing Address - Fax:215-969-2610
Practice Address - Street 1:9863 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-2611
Practice Address - Country:US
Practice Address - Phone:215-969-0100
Practice Address - Fax:215-969-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty