| NPI | 1063718229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMAN MOSTOVOY Licensed O PT Ician 347-587-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NY C009086) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-02-07 |