Provider Demographics
NPI:1982991857
Name:GREENLAWN VISION CENTER
Entity Type:Organization
Organization Name:GREENLAWN VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFFEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-261-3900
Mailing Address - Street 1:751A PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1710
Mailing Address - Country:US
Mailing Address - Phone:631-261-3900
Mailing Address - Fax:631-261-3150
Practice Address - Street 1:751A PULASKI RD
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1710
Practice Address - Country:US
Practice Address - Phone:631-261-3900
Practice Address - Fax:631-261-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5374-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier