Individual
ROMAN RAKHIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPT
Contact information
Practice address
224 SUNRISE MALL, MASSAPEQUA, NY 11758-4340
(516) 795-3030
Mailing address
143-26 84 TH RD, JAMAICA, NY 11435
(718) 262-0410
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007325
NY
Other
Enumeration date
05/25/2007
Last updated
11/14/2008
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