Provider Demographics
NPI:1689755019
Name:CHIN-SHUE, VERONICA E (OD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:E
Last Name:CHIN-SHUE
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 1:5124 72ND PL
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7622
Mailing Address - Country:US
Mailing Address - Phone:718-920-2020
Mailing Address - Fax:
Practice Address - Street 1:MMC - DEPT. OF OPHTHALMOLOGY
Practice Address - Street 2:3400 BAINBRIDGE AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004390152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist