Provider Demographics
NPI:1902214208
Name:WINTER, ANN SHARON (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:SHARON
Last Name:WINTER
Suffix:
Gender:F
Credentials:LICENSED OPTICIAN
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Mailing Address - Street 1:8635 QUEENS BLVD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4434
Mailing Address - Country:US
Mailing Address - Phone:718-672-4888
Mailing Address - Fax:718-672-7086
Practice Address - Street 1:8635 QUEENS BLVD
Practice Address - Street 2:SUITE 1D
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4434
Practice Address - Country:US
Practice Address - Phone:718-672-4888
Practice Address - Fax:718-672-7086
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY007707-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician