Individual
DR. TIMOTHY IP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
6539 175TH ST, FRESH MEADOWS, NY 11365-2137
(917) 769-9025
Mailing address
6539 175TH ST, FRESH MEADOWS, NY 11365-2137
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007418-1
NY
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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