Provider Demographics
NPI:1780859470
Name:ACCENT ON VISION EAST, LLC
Entity Type:Organization
Organization Name:ACCENT ON VISION EAST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D. OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUEMMELER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:505-293-3515
Mailing Address - Street 1:7121 PROSPECT PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4313
Mailing Address - Country:US
Mailing Address - Phone:505-239-3274
Mailing Address - Fax:
Practice Address - Street 1:7121 PROSPECT PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4313
Practice Address - Country:US
Practice Address - Phone:505-239-3274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM525302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization