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General NPI Number Information
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NPI Number | 1548034150
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Entity Type | Organization
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Legal Business Name | NEW DORP OPTICAL INC
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 2244 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3227
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Country | US
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Telephone | 718-233-8667
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Fax | 718-233-8649
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Provider Business Mailing Address
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Address Line | 2244 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3227
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Country | US
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Telephone | 718-233-8667
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Fax | 718-233-8649
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Authorized Official
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Title or Position | OWNER
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Name | YANCONG CHEN
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Credential |
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Telephone | 646-331-0777
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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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