Provider Demographics
NPI:1154446987
Name:CHIN, ALLEN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 80TH ST
Mailing Address - Street 2:FL 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1609
Mailing Address - Country:US
Mailing Address - Phone:718-259-2011
Mailing Address - Fax:
Practice Address - Street 1:15811 HARRY VAN ARSDALE JR AVE
Practice Address - Street 2:OPTICAL DEPT JOINT INDUSTRY BOARD
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365
Practice Address - Country:US
Practice Address - Phone:718-591-2014
Practice Address - Fax:718-591-9528
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 003892152W00000X
CT000892152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist