Individual
MRS. OMAWATHI DEBIDAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1152 GREEN ACRES MALL, VALLEY STREAM, NY 11581-1538
(516) 568-2020
Mailing address
1152 GREEN ACRES MALL, VALLEY STREAM, NY 11581-1538
(516) 568-2020
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007341-1
NY
Other
Enumeration date
12/11/2008
Last updated
12/11/2008
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