Provider Demographics
NPI:1578727624
Name:MOHSINI, WASIM (OD)
Entity Type:Individual
Prefix:
First Name:WASIM
Middle Name:
Last Name:MOHSINI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2921 ERIE BLVD E
Mailing Address - Street 2:EMPIRE VISION CENTER, INC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1430
Mailing Address - Country:US
Mailing Address - Phone:315-446-3145
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:140 ROUTE 104
Practice Address - Street 2:EMPIRE VISION CENTERS
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-5649
Practice Address - Country:US
Practice Address - Phone:315-342-0727
Practice Address - Fax:315-342-3044
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYTUV007311-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist