MEDICARE: IWANT2020 COM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	206774	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235281205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IWANT2020 COM INC

Provider Business Mailing Address
First Line	:	333 PARK AVE S
Second Line	:	1ST. FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10010-2906
Country	:	US
Telephone Number	:	212-741-8628
Fax Number	:	212-741-2390

Provider Business Practice Location Address
First Line	:	102 E 25TH ST
Second Line	:	GROUND FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10010-2906
Country	:	US
Telephone Number	:	212-741-8628
Fax Number	:	212-741-2390

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. EMIL W CHYNN
Credential	:	M.D.
Telephone Number	:	212-741-8626

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/21/2022

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