Healthcare Provider Details

I. General information

NPI: 1104298710
Provider Name (Legal Business Name): HUASHI EYEWEAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5302 8TH AVE
BROOKLYN NY
11220-6849
US

IV. Provider business mailing address

277 GOLD ST APT 5N
BROOKLYN NY
11201-3114
US

V. Phone/Fax

Practice location:
  • Phone: 626-321-6663
  • Fax:
Mailing address:
  • Phone: 626-321-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV007981
License Number StateNY

VIII. Authorized Official

Name: DR. ELLEN HUI
Title or Position: OPTOMETRIST
Credential:
Phone: 626-321-6663