Provider Demographics
NPI:1760677116
Name:VISION CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:VISION CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:COGAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-252-5711
Mailing Address - Street 1:187 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3310
Mailing Address - Country:US
Mailing Address - Phone:315-252-5711
Mailing Address - Fax:315-252-8171
Practice Address - Street 1:187 GENESEE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3310
Practice Address - Country:US
Practice Address - Phone:315-252-5711
Practice Address - Fax:315-252-8171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003728-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4627320001Medicare NSC
NYAA1451Medicare PIN