Provider Demographics
NPI:1982647541
Name:SYN, SUNNY SIEW CHUAN (OD)
Entity Type:Individual
Prefix:DR
First Name:SUNNY SIEW CHUAN
Middle Name:
Last Name:SYN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:SUNNY SIEW CHUAN
Other - Middle Name:
Other - Last Name:SYN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:49 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:KINGS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1239
Mailing Address - Country:US
Mailing Address - Phone:718-498-2020
Mailing Address - Fax:718-498-1020
Practice Address - Street 1:1680 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5605
Practice Address - Country:US
Practice Address - Phone:718-498-2020
Practice Address - Fax:718-498-1020
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01084880Medicaid
NYC62561Medicare PIN
NY01084880Medicaid