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General NPI Number Information
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NPI Number | 1235630831
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Entity Type | Organization
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Legal Business Name | EAST HARLEM EYE CARE, LLC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 2249 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10029-2266
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Country | US
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Telephone | 718-869-4326
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Fax |
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Provider Business Mailing Address
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Address Line | 2249 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10029-2266
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Country | US
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Telephone | 718-869-4326
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Fax | 347-987-4474
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Authorized Official
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Title or Position | OWNER
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Name | MINH VU
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Credential | OD
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Telephone | 718-965-1320
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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 | TUV008554
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 138815
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License Number State | NY
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