Individual
MARINA SU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ORT007901
NY
152W00000X
Optometrist
TLG14499
CA
152W00000X
Optometrist
Primary
TUV007901
NY
Other
Enumeration date
08/15/2012
Last updated
01/15/2026
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