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General NPI Number Information
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NPI Number | 1609244698
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Entity Type | Organization
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Legal Business Name | HJ VISION CORP.
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 115-11 LIBERTY AVENUE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1158
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Country | US
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Telephone | 718-846-0824
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Fax | 718-846-0801
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Provider Business Mailing Address
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Address Line | 115-11 LIBERTY AVENUE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1158
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Country | US
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Telephone | 718-846-0824
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Fax | 718-846-0801
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Authorized Official
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Title or Position | OWNER / OPTICIAN
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Name | JUNG KWANG PARK
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Credential | O.D
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Telephone | 718-846-0824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 007311-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #3
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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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