Individual
SERENA SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005692-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2284264
UNITED HEALTHCARE
NY
01
—
4C5916
HEALTHNET
NY
01
—
7290443
AETNA
NY
01
—
C279H1
EMPIRE BLUE SHIELD
NY
01
—
MVP
393760
NY
01
—
P2803098
OXFORD
NY
Enumeration date
08/01/2006
Last updated
10/04/2011
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