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General NPI Number Information
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NPI Number | 1447805676
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Entity Type | Individual
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Provider Name | DR. ELKIE FUNG
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Gender | Female
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 33 W 42ND ST
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City | NEW YORK
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State | NY
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Zip | 10036-8005
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Country | US
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Telephone | 929-354-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 105 W 55TH ST APT 9D
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City | NEW YORK
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State | NY
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Zip | 10019-5337
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Country | US
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Telephone | 929-354-6505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TUV008973-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | TUV008973-01
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License Number State | NY
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