Individual
MR. MOHAMED FEROZE BACCHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN OPHTHALMIC
Contact information
Practice address
356 19TH ST, NEW YORK, NY 10003
(212) 674-4121
Mailing address
356 19TH ST, NEW YORK, NY 10003
(212) 674-4121
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C005355
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01338403
—
NY
Enumeration date
10/18/2006
Last updated
07/08/2007
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