Provider Demographics
NPI:1578757100
Name:BELLE VISION CENTER, INC.
Entity Type:Organization
Organization Name:BELLE VISION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRUZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-929-2229
Mailing Address - Street 1:710 TRI COUNTY LN
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1987
Mailing Address - Country:US
Mailing Address - Phone:724-929-2229
Mailing Address - Fax:
Practice Address - Street 1:710 TRI COUNTY LN
Practice Address - Street 2:TRI-COUNTY PLAZA
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1987
Practice Address - Country:US
Practice Address - Phone:724-929-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET009040332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0428690001Medicare NSC
PA161030Medicare PIN