Provider Demographics
NPI:1821161944
Name:WESTWAY VISION, INC.
Entity Type:Organization
Organization Name:WESTWAY VISION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TANZIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-245-0686
Mailing Address - Street 1:756 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5002
Mailing Address - Country:US
Mailing Address - Phone:212-245-0686
Mailing Address - Fax:212-245-6305
Practice Address - Street 1:756 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5002
Practice Address - Country:US
Practice Address - Phone:212-245-0686
Practice Address - Fax:212-245-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005033152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0133130001Medicare PIN