Individual
YURIY NEKTALOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIANRY
Contact information
Practice address
500 3RD AVE, NEW YORK, NY 10016-4853
(646) 750-0118
Mailing address
500 3RD AVE, NEW YORK, NY 10016-4853
(646) 750-0118
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009720-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009720-1
STATE OF NEW YORK
—
05
—
009720-1
—
NY
Enumeration date
01/04/2019
Last updated
12/27/2024
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