Individual
JULIA POLTILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7259 KISSENA BLVD STE 1, FLUSHING, NY 11367-2165
(718) 263-2020
Mailing address
20504 HILLSIDE AVE, HOLLIS, NY 11423-2218
(718) 464-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009534
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2022
Last updated
07/25/2022
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