Organization
FOURTH AVENUE VISION CENTER
Active
Other names
Fourth Avenue Vision Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CLAIRE LUCADAMO (OWNER)
(914) 664-4600
Entity
Organization
Contact information
Practice address
55 S. FOURTH AVE., MT. VERNON, NY 10550-3104
(914) 664-4600
Mailing address
55 S 4TH AVE, MT VERNON, NY 10550-3104
(914) 664-4600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002488
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02902789
—
NY
Enumeration date
05/23/2007
Last updated
10/04/2007
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