Organization
MY OPTICIAN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARAT SHLIMOV (OWNER/OPTICIAN)
(718) 495-8801
Entity
Organization
Contact information
Practice address
9516 CHURCH AVE, BROOKLYN, NY 11212-2434
(718) 495-8801
Mailing address
9516 CHURCH AVE, BROOKLYN, NY 11212-2434
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007320
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02104543
—
NY
Enumeration date
03/10/2006
Last updated
06/18/2010
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