Individual
ALLA DYATLOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
139 FLATBUSH AVE, ATLANTIC TERMINAL MALL, BROOKLYN, NY 11217-1450
(718) 522-3737
(718) 522-3894
Mailing address
139 FLATBUSH AVE, ATLANTIC TERMINAL MALL, BROOKLYN, NY 11217-1450
(718) 522-3737
(718) 522-3894
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006774-1
NY
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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