| NPI | 1639590128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY KIMYAGAROVA Optician/Manager 212-764-6133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 00053991) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |