Provider Demographics
NPI:1285802454
Name:QUEENS VISION CENTER INC
Entity type:Organization
Organization Name:QUEENS VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-803-0178
Mailing Address - Street 1:8112 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2450
Mailing Address - Country:US
Mailing Address - Phone:718-803-0178
Mailing Address - Fax:718-672-1509
Practice Address - Street 1:8112 BROADWAY
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2020-07-28
Deactivation Date:2019-08-22
Deactivation Code:
Reactivation Date:2020-07-28
Provider Licenses
StateLicense IDTaxonomies
NYTUV006737152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty