Healthcare Provider Details

I. General information

NPI: 1750113098
Provider Name (Legal Business Name): TRACY TSE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WALKER ST
NEW YORK NY
10013-4135
US

IV. Provider business mailing address

125 WALKER ST
NEW YORK NY
10013-4135
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-3888
  • Fax: 212-334-6887
Mailing address:
  • Phone: 212-226-8866
  • Fax: 212-226-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number010009
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: