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General NPI Number Information
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NPI Number | 1235660705
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Entity Type | Organization
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Legal Business Name | JASON CHEUNG, OD, LLC
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Dates
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Enumeration Date | 03/25/2017
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 260 W SUNRISE HWY
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City | VALLEY STREAM
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State | NY
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Zip | 11581-1011
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Country | US
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Telephone | 167-912-7905
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Fax | 516-791-2797
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Provider Business Mailing Address
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Address Line | 519 BORDEN AVE APT 9L
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5899
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Country | US
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Telephone | 917-731-1564
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JASON CHEUNG
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Credential | OD
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Telephone | 516-791-2790
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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 | TUV008269
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License Number State | NY
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