Healthcare Provider Details

I. General information

NPI: 1861052714
Provider Name (Legal Business Name): ILOOK 3.0 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13679 ROOSEVELT AVE
FLUSHING NY
11354-5652
US

IV. Provider business mailing address

8504 18TH AVE
BROOKLYN NY
11214-2913
US

V. Phone/Fax

Practice location:
  • Phone: 718-801-8980
  • Fax:
Mailing address:
  • Phone: 718-621-6305
  • Fax: 718-621-6307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM LING
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 718-439-2880