Provider Demographics
NPI:1760456347
Name:CHUANG, JAMES (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CHUANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 VIETOR AVE SUITE P1
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3260
Mailing Address - Country:US
Mailing Address - Phone:718-803-0178
Mailing Address - Fax:718-672-1509
Practice Address - Street 1:8330 VIETOR AVENUE, SUITE P1
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2450
Practice Address - Country:US
Practice Address - Phone:718-803-0178
Practice Address - Fax:718-672-1509
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006737152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02705571Medicaid
NYV04248Medicare UPIN
NY02705571Medicaid