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General NPI Number Information
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NPI Number | 1225841190
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Entity Type | Organization
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Legal Business Name | JING YANG VISION SOURCE INC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 4111 PARSONS BLVD APT 505
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City | FLUSHING
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State | NY
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Zip | 11355-1900
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Country | US
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Telephone | 857-384-0312
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Fax |
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Provider Business Mailing Address
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Address Line | 4111 PARSONS BLVD APT 505
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City | FLUSHING
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State | NY
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Zip | 11355-1900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. YANG JING
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Credential | OD
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Telephone | 857-384-0312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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