Healthcare Provider Details

I. General information

NPI: 1154344075
Provider Name (Legal Business Name): 519 EYECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 E FORDHAM RD
BRONX NY
10468-5408
US

IV. Provider business mailing address

138 E FORDHAM RD
BRONX NY
10468-5408
US

V. Phone/Fax

Practice location:
  • Phone: 718-933-0188
  • Fax: 718-364-7300
Mailing address:
  • Phone: 718-933-0188
  • Fax: 718-364-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4946
License Number StateNY

VIII. Authorized Official

Name: DR. SIEW CHUAN SIN
Title or Position: VICE PRESIDENT
Credential: O.D
Phone: 718-933-0188