Organization
EYELLUSION VISION CENTER INCORPORATED
Active
Other names
eyellusion vision center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMINIO V FERNANDEZ OPTICIAN (PRESIDENT)
(718) 639-1392
Entity
Organization
Contact information
Practice address
6909 ROOSEVELT AVE, WOODSIDE, NY 11377-2933
(718) 639-1392
(718) 639-2041
Mailing address
6909 ROOSEVELT AVE, WOODSIDE, NY 11377-2933
(718) 639-1392
(718) 639-2041
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006666
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02291789
—
NY
01
—
205119
COLE MANAGED
NY
01
—
333641
NVA
NY
01
—
44101
DAVIS VISION
NY
01
—
5499979
GHI
NY
01
—
7186391392
HIP
NY
01
—
EV14830
SPECTERA
NY
01
—
NY6666
EYEMED
NM
Enumeration date
07/05/2006
Last updated
08/03/2015
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