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Individual

SERENA SHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
7 MILLER RD, MAHOPAC, NY 10541-2219
(845) 628-8788
(845) 628-9581
Mailing address
PO BOX 959, MAHOPAC, NY 10541-0959
(845) 628-8788
(845) 628-9581

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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