Provider Demographics
NPI:1942291273
Name:NATIONAL VISION CENTER
Entity Type:Organization
Organization Name:NATIONAL VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADOLPHUS
Authorized Official - Middle Name:CHUKWUGOZIE
Authorized Official - Last Name:ANOSIKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-693-5994
Mailing Address - Street 1:820 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3102
Mailing Address - Country:US
Mailing Address - Phone:718-693-5994
Mailing Address - Fax:718-693-6284
Practice Address - Street 1:820 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3102
Practice Address - Country:US
Practice Address - Phone:718-693-5994
Practice Address - Fax:718-693-6284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT49085Medicare UPIN