Individual
DR. GRIGORIY SHIMONOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
15614 CROSSBAY BLVD, HOWARD BEACH, NY 11414-2745
(718) 738-2020
Mailing address
15614 CROSSBAY BLVD, HOWARD BEACH, NY 11414-2745
(718) 738-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006831
NY
152WC0802X
Corneal and Contact Management Optometrist
TUV006831
NY
Other
Enumeration date
08/02/2005
Last updated
01/19/2024
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