Provider Demographics
NPI:1508405689
Name:MODERN EYES OPTICAL LLC
Entity Type:Organization
Organization Name:MODERN EYES OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-916-0532
Mailing Address - Street 1:5020 8TH AVE
Mailing Address - Street 2:MODERN EYES OPTICAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:347-916-0532
Mailing Address - Fax:347-916-0534
Practice Address - Street 1:5020 8TH AVE
Practice Address - Street 2:MODERN EYES OPTICAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:347-916-0532
Practice Address - Fax:347-916-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty