Provider Demographics
NPI:1588383996
Name:JENNIFER CHIN OD PLLC
Entity type:Organization
Organization Name:JENNIFER CHIN OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-309-1026
Mailing Address - Street 1:8002 KEW GARDENS RD STE C108
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3609
Mailing Address - Country:US
Mailing Address - Phone:718-544-2222
Mailing Address - Fax:718-544-7350
Practice Address - Street 1:8002 KEW GARDENS RD STE C108
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3609
Practice Address - Country:US
Practice Address - Phone:718-544-2222
Practice Address - Fax:718-544-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty