MEDICARE: SHINE EYECARE CORP

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1538004189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHINE EYECARE CORP

Provider Business Mailing Address
First Line	:	291 BEDFORD AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4226
Country	:	US
Telephone Number	:	718-218-8866
Fax Number	:	718-218-8869

Provider Business Practice Location Address
First Line	:	291 BEDFORD AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4226
Country	:	US
Telephone Number	:	718-218-8866
Fax Number	:	718-218-8869

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNY MA
Credential	:
Telephone Number	:	917-701-2211

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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Directions to “SHINE EYECARE CORP ” Practice Location

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