Provider Demographics
NPI:1184497240
Name:BRONX VISION GROUP INC
Entity type:Organization
Organization Name:BRONX VISION GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:YEZENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALER
Authorized Official - Phone:347-324-4207
Mailing Address - Street 1:665 PELHAM PKWY N STE. # 102
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8069
Mailing Address - Country:US
Mailing Address - Phone:929-579-0321
Mailing Address - Fax:208-955-2512
Practice Address - Street 1:665 PELHAM PKWY N STE. # 102
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8069
Practice Address - Country:US
Practice Address - Phone:718-547-2020
Practice Address - Fax:718-547-3021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty