Basic Information
| Provider Information | |||||||||
| NPI: | 1679913446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUAN | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2850 WALKER DR | ||||||||
| Address2: | |||||||||
| City: | YORKTOWN HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105982916 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3901 OLEANDER DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284036733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103952772 | ||||||||
| FaxNumber: | 9107999170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2013 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | TUV 56007999 | NY | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 2564 | NC | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.