Individual
SHIVANI TANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6806 BAY PKWY, BROOKLYN, NY 11204-5524
(718) 236-4352
Mailing address
2730 HAWTHORNE DR S, SHELBY TOWNSHIP, MI 48316-5541
(586) 258-6181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009833
NY
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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