Provider Demographics
NPI:1588651434
Name:YING, HEIDI (OD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:YING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1511
Mailing Address - Country:US
Mailing Address - Phone:607-754-4426
Mailing Address - Fax:
Practice Address - Street 1:157 FRONT ST
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1511
Practice Address - Country:US
Practice Address - Phone:607-754-4426
Practice Address - Fax:607-754-0464
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006127152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
598900OtherMVP
0679800001OtherDME REGION A
10043432OtherCDPHP
NYRA0624OtherUPSTATE MEDICARE
598900OtherMVP
NYU75476Medicare UPIN