Individual
SVETLANA KATANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
10423 OUEENS BLVD, FOREST HILLS, NY 11375
(718) 275-2500
Mailing address
6524 ELLWELL CRES, REGO PARK, NY 11374-5032
(718) 459-7973
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT 6255-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02645590
—
NY
Enumeration date
01/04/2007
Last updated
07/08/2007
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