Healthcare Provider Details

I. General information

NPI: 1174556708
Provider Name (Legal Business Name): METRO OPTICS EYEWEAR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 METROPOLITAN AVE SUITE D
BRONX NY
10462-7978
US

IV. Provider business mailing address

1332 METROPOLITAN AVE SUITE D
BRONX NY
10462-7978
US

V. Phone/Fax

Practice location:
  • Phone: 718-829-5605
  • Fax: 718-829-6632
Mailing address:
  • Phone: 718-829-5605
  • Fax: 718-829-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. EVA YAN
Title or Position: VICE PRESIDENT / OPTOMETRIST
Credential: O. D.
Phone: 718-829-5605