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General NPI Number Information
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NPI Number | 1972107076
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Entity Type | Individual
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Provider Name | NA LA SHIN
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 192 SUMMERHILL RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4950
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Country | US
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Telephone | 732-257-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 23 OCEANIC AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6511
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Country | US
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Telephone | 718-948-8880
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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 | 27OA00702300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV009290-01
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License Number State | NY
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