Eyesite Vision Center

LBN: Clement Idehen Optometrist Pc
Eyesite Vision Center is an health care organization with primary practice located at 5546 Myrtle Ave , Ridgewood NY 11385-3554. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Clement Idehen Optometrist Pc can be contacted via phone (718) 628-9200, or through Idehen, Clement Enorense via phone (718) 628-9200.

Contact Information

Primary practice address
5546 Myrtle Ave Ridgewood NY 11385-3554
Phone: (718) 628-9200
Fax: (718) 628-5600
Website:
Map and Directions
Authorized official contact:
Name: Idehen, Clement Enorense Doctor of Optometry (OD)
Phone: (718) 628-9200

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T006065 New York

Profile Details

NPI number 1760435374
LBN Legal business name Clement Idehen Optometrist Pc
DBA Doing business as Eyesite Vision Center
Authorized official Idehen, Clement Enorense Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Sep 16th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760435374 NPPES
New York MEDICAID 02263261

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