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General NPI Number Information
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NPI Number | 1578711099
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Entity Type | Organization
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Legal Business Name | ALY EYECARE CENTER INC.
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 5202 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-2709
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Country | US
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Telephone | 718-492-0515
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Fax | 718-492-4982
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Provider Business Mailing Address
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Address Line | 5202 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-2709
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Country | US
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Telephone | 718-492-0515
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Fax | 718-492-4982
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN YAN
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Credential | OD
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Telephone | 718-492-0515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | TUV006425
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License Number State | NY
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