Provider Demographics
NPI:1962469668
Name:EMPIRE VISION CENTER INC
Entity Type:Organization
Organization Name:EMPIRE VISION CENTER INC
Other - Org Name:CAMBRIDGE EYE DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SLV
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:THROWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-446-3145
Mailing Address - Street 1:2921 ERIE BLVD EAST
Mailing Address - Street 2:EMPIRE VISION CENTER INC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224
Mailing Address - Country:US
Mailing Address - Phone:315-446-3145
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:75 WASHINGTON STREET, SUITE 3
Practice Address - Street 2:CAMBRIDGE EYE DOCTORS
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359
Practice Address - Country:US
Practice Address - Phone:781-826-5117
Practice Address - Fax:781-826-0954
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPIRE VISION CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-27
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0505220070Medicare NSC