Healthcare Provider Details

I. General information

NPI: 1598684276
Provider Name (Legal Business Name): TIFFANY LILY TING OD
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13329 41ST RD STE 2B
FLUSHING NY
11355-3671
US

IV. Provider business mailing address

13329 41ST RD STE 2B
FLUSHING NY
11355-3671
US

V. Phone/Fax

Practice location:
  • Phone: 718-314-5757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011431
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: