Provider Demographics
NPI:1538772157
Name:WILZEN ANNE LINGAD O.D., PLLC
Entity type:Organization
Organization Name:WILZEN ANNE LINGAD O.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILZEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINGAD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-675-2263
Mailing Address - Street 1:386 WARREN ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4117 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3861
Practice Address - Country:US
Practice Address - Phone:718-786-5892
Practice Address - Fax:929-273-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty