Provider Demographics
NPI:1417580382
Name:YONG, MEGNE (OPTICIAN/ OWNER)
Entity Type:Individual
Prefix:MS
First Name:MEGNE
Middle Name:
Last Name:YONG
Suffix:
Gender:F
Credentials:OPTICIAN/ OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3193
Mailing Address - Country:US
Mailing Address - Phone:845-353-3515
Mailing Address - Fax:845-353-3516
Practice Address - Street 1:79 MAIN ST
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3193
Practice Address - Country:US
Practice Address - Phone:845-353-3515
Practice Address - Fax:845-353-3516
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007256-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician