Individual
EDUARD SHIMANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21411 73RD AVE, OAKLAND GARDENS, NY 11364-2947
(718) 225-5533
Mailing address
6922 184TH ST, FRESH MEADOWS, NY 11365-3538
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007264
NY
Other
Enumeration date
03/17/2007
Last updated
07/08/2007
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