Provider Demographics
NPI:1962461467
Name:VISION EXPRESS OPTICIANS
Entity Type:Organization
Organization Name:VISION EXPRESS OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:DORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-344-3278
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-0107
Mailing Address - Country:US
Mailing Address - Phone:585-344-3278
Mailing Address - Fax:585-344-3278
Practice Address - Street 1:6 COURT ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3128
Practice Address - Country:US
Practice Address - Phone:585-344-3278
Practice Address - Fax:585-344-3278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty