Individual
YELENA YUSUPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 CENTRAL AVE UNIT A, CEDARHURST, NY 11516-1930
(516) 303-2410
Mailing address
415 CENTRAL AVE UNIT A, CEDARHURST, NY 11516-1930
(516) 303-2410
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
010097
NY
Other
Enumeration date
01/02/2023
Last updated
01/02/2023
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