Provider Demographics
NPI:1174556708
Name:METRO OPTICS EYEWEAR, INC
Entity type:Organization
Organization Name:METRO OPTICS EYEWEAR, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:718-829-5605
Mailing Address - Street 1:1332 METROPOLITAN AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7978
Mailing Address - Country:US
Mailing Address - Phone:718-829-5605
Mailing Address - Fax:718-829-6632
Practice Address - Street 1:1332 METROPOLITAN AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7978
Practice Address - Country:US
Practice Address - Phone:718-829-5605
Practice Address - Fax:718-829-6632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00343893Medicaid
NY00343893Medicaid
NY0475220001Medicare NSC