Individual
REBECCA REVITAL KHALILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9141 QUEENS BLVD, ELMHURST, NY 11373-5531
(210) 524-6922
Mailing address
8016 193RD ST, HOLLIS, NY 11423-1046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008268-1
NY
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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