Organization
DIANA PAN OPTOMETRIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA PAN (SOLE MEMBER)
(516) 459-1342
Entity
Organization
Contact information
Practice address
28 ROEBLING ST, BROOKLYN, NY 11211
(516) 459-1342
Mailing address
15816 79TH AVE APT N307, FRESH MEADOWS, NY 11366-1098
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/08/2022
Last updated
09/22/2022
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