Provider Demographics
NPI:1538386669
Name:VISION QUEST OF WEST 180TH STREET INC.
Entity type:Organization
Organization Name:VISION QUEST OF WEST 180TH STREET INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-543-4714
Mailing Address - Street 1:1403 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4021
Mailing Address - Country:US
Mailing Address - Phone:212-543-4714
Mailing Address - Fax:212-543-4767
Practice Address - Street 1:1403 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4021
Practice Address - Country:US
Practice Address - Phone:212-543-4714
Practice Address - Fax:212-543-4767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTOO5254152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty