Individual
TARA M. MAHVELATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
33 W 42ND ST - SUNY COLLEGE OF OPTOMETRY, NEW YORK, NY 10036-8005
(347) 972-8292
Mailing address
33 W 42ND ST SUNY - COLLEGE OF OPTOMETRY, NEW YORK, NY 10036-8005
(347) 972-8292
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV-008993
NY
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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