Provider Demographics
NPI:1750358826
Name:EMPIRE VISION CENTER INC
Entity type:Organization
Organization Name:EMPIRE VISION CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:THROWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-446-3145
Mailing Address - Street 1:2921 ERIE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224
Mailing Address - Country:US
Mailing Address - Phone:315-446-3145
Mailing Address - Fax:315-445-7665
Practice Address - Street 1:2921 ERIE BLVD E
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224
Practice Address - Country:US
Practice Address - Phone:315-446-3145
Practice Address - Fax:315-445-7665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CVW832Medicare ID - Type UnspecifiedGROUP
10562AMedicare ID - Type UnspecifiedGROUP
53061AMedicare ID - Type UnspecifiedGROUP
029600Medicare ID - Type UnspecifiedGROUP
53069AMedicare ID - Type UnspecifiedGROUP
AA0096Medicare ID - Type UnspecifiedGROUP