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Individual

LIDIA MULLAEV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1039 3RD AVE, NEW YORK, NY 10065-8110
(718) 216-8181
Mailing address
1039 3RD AVE, NEW YORK, NY 10065-8110
(718) 216-8181

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007584-1
NY

Other

Enumeration date
04/19/2012
Last updated
04/19/2012
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