Organization
NY OPTOMETRIST VISION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD FUZAYLOV O.D. (OWNER)
(718) 591-3000
Entity
Organization
Contact information
Practice address
15036 UNION TPKE, FLUSHING, NY 11367-3928
(718) 591-3000
Mailing address
15036 UNION TPKE, FLUSHING, NY 11367-3928
(718) 591-3000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008487
NY
Other
Enumeration date
05/21/2018
Last updated
06/19/2019
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