Individual
MISS ANGELA V DUSSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1016 50TH AVE, LONG ISLAND CITY, NY 11101-6273
(516) 792-6901
Mailing address
1016 50TH AVE, LONG ISLAND CITY, NY 11101-6273
(516) 792-6901
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
007777
NY
152WC0802X
Corneal and Contact Management Optometrist
Primary
007777
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205115474
—
NY
Enumeration date
08/05/2011
Last updated
08/23/2019
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