Individual
SERAFIMA NISIMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
9519 63RD DR, REGO PARK, NY 11374-2024
(718) 459-2020
Mailing address
8207 TRYON PL, JAMAICA, NY 11432-1440
(718) 844-4731
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009572
NY
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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