| NPI | 1851678809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT YUSUPOV Owner/O PT Ician 347-808-9155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV007499) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |