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Individual

MARVEA V THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OPTICIAN

Contact information

Practice address
1033 GREEN ACRES MALL, VALLEY STREAM, NY 11581-1531
(516) 825-8990
(516) 872-2702
Mailing address
21 OAKFIELD AVE, FREEPORT, NY 11520-1913
(516) 825-8990

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006417-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02000439
NY
Enumeration date
04/10/2007
Last updated
02/01/2012
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