Healthcare Provider Details

I. General information

NPI: 1285519892
Provider Name (Legal Business Name): FOREST EYE CARE OPTOMETRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107-40 QUEENS BLVD PROFESSIONAL LOBBY 1ST FL
FOREST HILLS NY
11375
US

IV. Provider business mailing address

10740 QUEENS BLVD
FOREST HILLS NY
11375-4200
US

V. Phone/Fax

Practice location:
  • Phone: 929-556-6651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. VANESSA WANG
Title or Position: OPTOMETRIST
Credential: OD
Phone: 929-556-6651