Organization
ELIJAH PETERS OPTIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILIA BOROKHOV (OWNER)
(718) 216-8181
Entity
Organization
Contact information
Practice address
1039 3RD AVE, NEW YORK, NY 10065-8110
(718) 216-8181
Mailing address
1039 3RD AVE, NEW YORK, NY 10065-8110
(718) 216-8181
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007584-1
NY
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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