Healthcare Provider Details

I. General information

NPI: 1679495287
Provider Name (Legal Business Name): MUHAN SUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W 42ND ST
NEW YORK NY
10036-8005
US

IV. Provider business mailing address

9810 63RD RD APT 1510
REGO PARK NY
11374-5418
US

V. Phone/Fax

Practice location:
  • Phone: 212-938-4001
  • Fax: 212-938-5831
Mailing address:
  • Phone: 971-727-9632
  • Fax: 971-727-9632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number011477
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: