Provider Demographics
NPI:1023198595
Name:CHINATOWN OPTICAL INC.
Entity Type:Organization
Organization Name:CHINATOWN OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:YUN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-431-8188
Mailing Address - Street 1:40 MOTT ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5011
Mailing Address - Country:US
Mailing Address - Phone:212-267-1260
Mailing Address - Fax:212-431-8188
Practice Address - Street 1:40 MOTT ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5011
Practice Address - Country:US
Practice Address - Phone:212-267-1260
Practice Address - Fax:212-431-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01631034Medicaid
NY01631034Medicaid