| NPI | 1013681774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KULAK Owner/Authorized Official 917-715-2599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2024-01-26 |