Individual
JOLANTA AGNIESZKA WYKOWSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
6543 MYRTLE AVE, GLENDALE, NY 11385-7028
(718) 366-7850
(718) 366-7851
Mailing address
6543 MYRTLE AVE, GLENDALE, NY 11385-7028
(718) 366-7850
(718) 366-7851
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C008153-1
NY
Other
Enumeration date
04/14/2007
Last updated
07/08/2007
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