Healthcare Provider Details

I. General information

NPI: 1659823938
Provider Name (Legal Business Name): MUEN YANG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

7610 113TH ST APT 3
FOREST HILLS NY
11375-6588
US

V. Phone/Fax

Practice location:
  • Phone: 212-938-4001
  • Fax: 212-938-4020
Mailing address:
  • Phone: 315-572-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number008530
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: