| NPI | 1669401394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA DINA JACOBSON Proprietor 917-854-2430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV005630-1) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-22 |