Provider Demographics
NPI:1912967068
Name:DING, JASON (OD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:DING
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 1:5291 BUNTING AVENUE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V7E 5X3
Mailing Address - Country:CA
Mailing Address - Phone:347-922-6047
Mailing Address - Fax:
Practice Address - Street 1:100 ALBANY POST RD
Practice Address - Street 2:620-123
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1415
Practice Address - Country:US
Practice Address - Phone:347-922-6047
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 006938-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV07834Medicare UPIN
NYC431C1Medicare ID - Type Unspecified