Healthcare Provider Details

I. General information

NPI: 1982783254
Provider Name (Legal Business Name): JASON YEE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403 KINGS PLZ CONTACT LENS & VISION
BROOKLYN NY
11234-5221
US

IV. Provider business mailing address

5403 KINGS PLZ
BROOKLYN NY
11234-5221
US

V. Phone/Fax

Practice location:
  • Phone: 718-252-8333
  • Fax: 718-377-7847
Mailing address:
  • Phone: 718-252-8333
  • Fax: 718-377-7847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV006266
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: