Provider Demographics
NPI: | 1821392879 |
---|---|
Name: | EMERGING VISION, INC |
Entity Type: | Organization |
Organization Name: | EMERGING VISION, INC |
Other - Org Name: | STERLING OPTICAL #118 |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SAM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HERSKOWITZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 646-737-1515 |
Mailing Address - Street 1: | 520 8TH AVE |
Mailing Address - Street 2: | 900 |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10018-6507 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-729-5345 |
Mailing Address - Fax: | 212-729-5382 |
Practice Address - Street 1: | 1740C N SPRING ST |
Practice Address - Street 2: | |
Practice Address - City: | BEAVER DAM |
Practice Address - State: | WI |
Practice Address - Zip Code: | 53916-1106 |
Practice Address - Country: | US |
Practice Address - Phone: | 920-219-4010 |
Practice Address - Fax: | 920-219-4025 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-01-05 |
Last Update Date: | 2011-01-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332H00000X | Suppliers | Eyewear Supplier |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
01052011 | Other | APPLICATION DATE |