Provider Demographics
NPI:1750812426
Name:CLEAR VISION OPTICAL EXPRESS INC
Entity type:Organization
Organization Name:CLEAR VISION OPTICAL EXPRESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-625-3173
Mailing Address - Street 1:8215 189TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1006
Mailing Address - Country:US
Mailing Address - Phone:718-625-3173
Mailing Address - Fax:
Practice Address - Street 1:8215 189TH ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1006
Practice Address - Country:US
Practice Address - Phone:718-625-3173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004733152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty