Provider Demographics
NPI:1437823598
Name:CHIN, EUGENE (LDO)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 42ND ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2730
Mailing Address - Country:US
Mailing Address - Phone:212-729-1767
Mailing Address - Fax:
Practice Address - Street 1:526 FASHION AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4822
Practice Address - Country:US
Practice Address - Phone:716-300-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7822156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician