Provider Demographics
NPI:1790973360
Name:GVS@COHEN'S FASHION OPTICAL
Entity Type:Organization
Organization Name:GVS@COHEN'S FASHION OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-729-5300
Mailing Address - Street 1:520 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6507
Mailing Address - Country:US
Mailing Address - Phone:212-729-5300
Mailing Address - Fax:212-729-5382
Practice Address - Street 1:275 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6708
Practice Address - Country:US
Practice Address - Phone:212-691-1709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COHEN'S FASHION OPTICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service