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1598879637
LISA MARIA MODESTO
FOREST HILLS, NY
NPI
1598879637
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: NY TUV007078)
Enumeration Date
2006-08-18
Last Update Date
2008-02-27
Business Address
MISS LISA MARIA MODESTO O.D.
10933 71ST RD SUITE 2 C
FOREST HILLS, NY 11375-4867
Phone number: 718-261-3366
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Mailing Address
MISS LISA MARIA MODESTO O.D.
610 E 20TH ST APT 4E APT. 4 E
NEW YORK, NY 10009-1403
Phone number: 917-843-9639
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