Organization
KINGS VISTASITE EYECARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRY GUREVICH OD (OPTOMETRIST)
(917) 933-9090
Entity
Organization
Contact information
Practice address
1913 KINGS HWY, BROOKLYN, NY 11229-1313
(917) 933-9090
(917) 933-9092
Mailing address
1913 KINGS HWY, BROOKLYN, NY 11229-1313
(917) 933-9090
(917) 933-9092
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006118
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386731974
—
NY
Enumeration date
05/09/2013
Last updated
03/17/2020
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