Provider Demographics
NPI:1144401415
Name:FLUSHING OPTICAL INC
Entity Type:Organization
Organization Name:FLUSHING 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 1:37-29 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4106
Mailing Address - Country:US
Mailing Address - Phone:718-461-4700
Mailing Address - Fax:
Practice Address - Street 1:3729 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4106
Practice Address - Country:US
Practice Address - Phone:718-461-4700
Practice Address - Fax:718-321-9675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8399-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01442382Medicaid
NY0845080001Medicare NSC