ALEX MYUNGHWAN SHIN (NPI# 1356958094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356958094 |
| Entity Type | Individual |
| Full Name | ALEX MYUNGHWAN SHIN |
| Credential | OD |
| Practice Address |
79 Middleville Rd Northport NY 11768-2200 |
| Mailing Address |
1 Deer Path Ln Syosset NY 11791-6116 |
| Practice Telephone | 6312614400 |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2020-09-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | TUV009246-01 | NY | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376926709 | Alex Shin | Orthopaedic Surgery | 4300 Londonderry Rd, Harrisburg, PA 17109-5317 | 2015-07-02 |
| Street Address |
79 MIDDLEVILLE RD |
| City | NORTHPORT |
| State | NY |
| Zip Code | 11768-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417958471 | David Wayne Gately | Psychologist | 79 Middleville Rd, Va Medical Center, Psychology Service (116b), Northport, NY 11768-2200 | 2005-08-02 |
| 1497356174 | Cynthia Abigail Serrano-colon | Nurse Practitioner | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-11-08 |
| 1225636020 | Jessie Ryan Poznack | Pathology | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-10-14 |
| 1407460470 | Kimberly Ann Smith | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-07 |
| 1790398634 | Simrit Kaur Virk | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-29 |
| 1700499670 | Christine Palathinkal | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-28 |
| 1235748252 | Valerie Marie Campos | Registered Nurse | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-27 |
| 1124636634 | Da Som Kim | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-21 |
| 1518584341 | Irene Sofia Koutsidis | Social Worker | 79 Middleville Rd, Northport, NY 11768-2296 | 2020-06-27 |
| 1609498344 | Stephanie Guadagno | Licensed Practical Nurse | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-05-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649753088 | Tania Morris | Developmental Therapist | 130 Main St, #1, Northport, Ny 11768, Northport, NY 11768 | 2018-09-12 |
| 1639698343 | Karen Yuan Wong | Student in an Organized Health Care Education/Training Program | 79 Middleviille Rd., Optometry 123, Northport, NY 11768 | 2017-09-13 |
| 1821514795 | Village Speech and Language Pllc | Clinic/Center | 62 Makamah Beach Rd, Northport, NY 11768 | 2017-08-22 |
| 1073960415 | Dennis Falco | Private Vehicle | 5 Captain Richards Ln, Fort Salonga, NY 11768 | 2016-05-16 |
| 1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
| 1649649096 | Lillian Patricia Fais | Specialist | 26 Josephine Lane, Fort Salonga, NY 11768 | 2015-09-16 |
| 1427349505 | Kathleen Ann Korwasky | Occupational Therapist | 18 Dick Court, Northport, NY 11768 | 2011-04-25 |
| 1043448822 | Gianna Rose Ferranti | Dentist | 19 Winkle Point Road, Northport, NY 11768 | 2009-06-30 |
| 1861658213 | Barbara Ann Hansen | Registered Nurse | 78 Eatons Neck Rd, Northport, NY 11768 | 2008-08-05 |
| 1902060148 | Dana Ruth Cohen | Psychiatry & Neurology | 79 Middleville Road, Bldg 64, Northport Vamc, Northport, NY 11768 | 2008-07-16 |
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| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558815134 | Megan Watkins Kidd, Od, LLC | Optometrist | 13847 Moonlight Dr, Northport, AL 35475-2924 | 2016-08-11 |
| 1770776197 | Grace Tan | Optometrist | 834 Fort Salonga Rd Ste D, Northport, NY 11768-3157 | 2007-08-20 |
| 1396955068 | Anthony Riley Austin | Optometrist | 8204 Lake Sherwood Cir, Northport, AL 35473-8425 | 2007-05-23 |
| 1033250964 | Rose M Betz | Optometrist | 801 Applejack Blvd, Northport, AL 35473-3401 | 2007-02-12 |
| 1851355507 | Daniel B Levy | Optometrist | 737 Fort Salonga Rd, Rte 25a Davis Vision Cvs Shopping Center, Northport, NY 11768 | 2006-04-12 |
| 1679579189 | Lynn Anne Finnegan | Optometrist | Northport Vamc-optometry Service, 79 Middlevile Rd, Northport, NY 11768-2200 | 2005-06-21 |
| 1922615103 | Chanpreet Kataria | Optometrist | Northport Vamc, 79 Middleville Road, Northport, NY 11768 | 2020-09-30 |
| 1790398634 | Simrit Kaur Virk | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-29 |
| 1942824156 | Amy Patel | Optometrist | 801 Applejack Blvd, Northport, AL 35473-3401 | 2020-06-03 |
| 1477106201 | Sohail Sakkari | Optometrist | 79 Middleville Rd, Northport, NY 11768-2296 | 2019-07-21 |
| Find all providers in NORTHPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.