Provider Demographics
NPI:1760490726
Name:M & L VISION CENTER INC.
Entity Type:Organization
Organization Name:M & L VISION CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LESLIIE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ARNO
Authorized Official - Suffix:SR
Authorized Official - Credentials:OPHAHALMIC DISPENSER
Authorized Official - Phone:718-748-7061
Mailing Address - Street 1:7420 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228
Mailing Address - Country:US
Mailing Address - Phone:718-748-7061
Mailing Address - Fax:718-748-7061
Practice Address - Street 1:7420 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-748-7061
Practice Address - Fax:718-748-7061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005532-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC4R65OtherBUSINESSH
NY01479776Medicaid