Provider Demographics
NPI:1861849671
Name:JL VISION, INC
Entity Type:Organization
Organization Name:JL VISION, INC
Other - Org Name:VISIONARY OPTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-596-3740
Mailing Address - Street 1:306 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4336
Mailing Address - Country:US
Mailing Address - Phone:718-596-3740
Mailing Address - Fax:718-596-4023
Practice Address - Street 1:306 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4336
Practice Address - Country:US
Practice Address - Phone:718-596-3740
Practice Address - Fax:718-596-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-21
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006963152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty