Individual
MRS. LISA AMY MADLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
226 FLATBUSH AVE, BROOKLYN, NY 11217-4036
(718) 622-1880
Mailing address
940 MAYFIELD RD, WOODMERE, NY 11598-1606
(516) 374-9251
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
004687-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004687-1
OPTICIAN LICENSE
NY
Enumeration date
02/26/2007
Last updated
07/08/2007
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