Healthcare Provider Details

I. General information

NPI: 1235281205
Provider Name (Legal Business Name): IWANT2020 COM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E 25TH ST GROUND FLOOR
NEW YORK NY
10010-2906
US

IV. Provider business mailing address

333 PARK AVE S 1ST. FLOOR
NEW YORK NY
10010-2906
US

V. Phone/Fax

Practice location:
  • Phone: 212-741-8628
  • Fax: 212-741-2390
Mailing address:
  • Phone: 212-741-8628
  • Fax: 212-741-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number206774
License Number StateNY

VIII. Authorized Official

Name: DR. EMIL W CHYNN
Title or Position: PROVIDER
Credential: M.D.
Phone: 212-741-8626