Individual
MR. ERIC MANEVICH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LICENSED OPTICIAN
Contact information
Practice address
4011 HYLAN BLVD, STATEN ISLAND, NY 10308-3332
(718) 227-0929
(718) 227-0890
Mailing address
4011 HYLAN BLVD, STATEN ISLAND, NY 10308-3332
(718) 227-0929
(718) 227-0890
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006509
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01471989
—
NY
05
—
02738145
—
NY
Enumeration date
05/11/2006
Last updated
07/09/2007
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