Dussan, Angela V

Dussan, Angela V is an sole proprietor health care provider with primary practice located at 1016 50Th Ave , Long Island City NY 11101-6273. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Corneal and Contact Management is her primary health care specialty. Dussan, Angela V can be contacted via phone (516) 792-6901.

Contact Information

Primary practice address
1016 50Th Ave Long Island City NY 11101-6273
Phone: (516) 792-6901
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 007777 New York
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 007777 New York

Profile Details

NPI number 1205115474
LBN Legal business name Dussan, Angela V
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2011
Last updated Aug 23rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205115474 NPPES
New York MEDICAID 1205115474

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