Provider Demographics
NPI:1437456605
Name:MAO CHANG VISION CENTER
Entity Type:Organization
Organization Name:MAO CHANG VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-267-8888
Mailing Address - Street 1:72 MOTT ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-6500
Mailing Address - Country:US
Mailing Address - Phone:212-267-8888
Mailing Address - Fax:212-925-5939
Practice Address - Street 1:72 MOTT ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-6500
Practice Address - Country:US
Practice Address - Phone:212-267-8888
Practice Address - Fax:212-925-5939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007529-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty