Individual
ROMAN JAKUBOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPHTHALMIC DISPENSER
Contact information
Practice address
323 AVENUE X, BROOKLYN, NY 11223-5913
(718) 265-1900
Mailing address
323 AVENUE X, BROOKLYN, NY 11223-5913
(718) 265-1900
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008905
NY
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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