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Active NPI 1194585133 Organization (Entity Type 2)

Patchoque Vision Express Llc

Eyewear Supplier • Patchogue, NY

About Patchoque Vision Express Llc NPI 1194585133 Summary

Patchoque Vision Express Llc is a verified healthcare organization specializing in Eyewear Supplier operating in Patchogue, NY. Located at 499 SUNRISE HWY W STE 80, this facility provides patient care and medical services under National Provider Identifier (NPI) 1194585133.

Administrative operations and authorized compliance are overseen by Leonid Vayner (Owner).

The facility is associated with 2 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

499 Sunrise Hwy W Ste 80

Patchogue, NY 117722290

Telephone 6312892010

Authorized Official Information

Authorized Contact Name

Leonid Vayner

Title / Role

Owner

Official Telephone

9177481570

Facility Classifications & Specialties

Eyewear Supplier Primary Taxonomy

NUCC Taxonomy Code: 332H00000X

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

2 Linked
John Demartino NPI 1265257141

Optometrist

Patchogue, NY

View Practitioner Profile →

Optometrist

Patchogue, NY

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 06, 2024

Eyewear Supplier

NPI Profile Active March 19, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location March 19, 2024

Registered at 499 SUNRISE HWY W STE 80, PATCHOGUE, NY 117722290 (Tel: 6312892010)

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Updated Business Mailing Address March 19, 2024

Registered at 499 SUNRISE HWY W STE 80, PATCHOGUE, NY 117722290 (Tel: 6312892010)

🏛️
Organization / Clinic Name Updated March 19, 2024

Operating as PATCHOQUE VISION EXPRESS LLC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 19, 2024

Optometrist

🟢
Initial NPI Registration & Enumeration March 19, 2024

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1194585133
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: March 19, 2024
Last Update: June 06, 2024

Mailing Address

499 Sunrise Hwy W Ste 80

Patchogue, NY 117722290

Phone: 6312892010

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.