| NPI | 1467836551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAISA MISHPATOVA Administrator 718-755-0656 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007654-1) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |