Provider Demographics
NPI:1972708550
Name:VISIONIQUE INC
Entity Type:Organization
Organization Name:VISIONIQUE INC
Other - Org Name:VISIONIQUE FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMAINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:347-489-5957
Mailing Address - Street 1:110 LOCKWOOD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5028
Mailing Address - Country:US
Mailing Address - Phone:914-636-5506
Mailing Address - Fax:914-636-6644
Practice Address - Street 1:110 LOCKWOOD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5028
Practice Address - Country:US
Practice Address - Phone:914-636-5506
Practice Address - Fax:914-636-6644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5465-1261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01712096Medicaid
NYCEWGD1Medicare PIN
NYC221C1Medicare UPIN
NY5004150001Medicare NSC