Provider Demographics
NPI:1730485640
Name:EYECARE ADVANTAGE,INC. EYECARE VISION SERVICES
Entity type:Organization
Organization Name:EYECARE ADVANTAGE,INC. EYECARE VISION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ASHINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:855-423-3700
Mailing Address - Street 1:1953 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2820
Mailing Address - Country:US
Mailing Address - Phone:855-423-3700
Mailing Address - Fax:631-499-3062
Practice Address - Street 1:1324 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7971
Practice Address - Country:US
Practice Address - Phone:855-423-3700
Practice Address - Fax:631-499-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3162152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG4000033355Medicare UPIN