Healthcare Provider Details

I. General information

NPI: 1326176249
Provider Name (Legal Business Name): 8TH AVE OPHTHALMOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 55TH STREET
BROOKLYN NY
11220
US

IV. Provider business mailing address

757 55TH STREET
BROOKLYN NY
11220
US

V. Phone/Fax

Practice location:
  • Phone: 718-437-9282
  • Fax: 718-437-9282
Mailing address:
  • Phone: 718-437-9282
  • Fax: 718-437-9284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. KATHY KWOK FUN MAN-WONG
Title or Position: PRESIDENT
Credential: M.D
Phone: 718-437-9282