Individual
KRISTIN ANN PROTOSOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTOMETRIST, OD
Contact information
Practice address
624 HAWKINS AVE, SUITE 1, RONKONKOMA, NY 11779-2375
(631) 588-5100
(631) 588-5185
Mailing address
624 HAWKINS AVE., SUITE 1, RONKONKOMA, NY 11779
(631) 588-5100
(631) 588-5185
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
TUV007254-1
NY
Other
Enumeration date
05/05/2008
Last updated
11/18/2011
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