Individual
MICHELLE QUEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
85 CROOKED HILL RD, COMMACK, NY 11725-5407
(631) 864-1975
(631) 864-2173
Mailing address
122 RIVERSIDE AVE, MASTIC BEACH, NY 11951-1114
(631) 672-6445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009196-1
NY
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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