Individual
JACOB C SHAFRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1901 UTICA AVE, BROOKLYN, NY 11234
(718) 968-8700
(718) 968-8743
Mailing address
26 LAFAYETTE DR, WOODMERE, NY 11598
(516) 569-2129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
UVT4560
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0910073
—
NY
Enumeration date
09/15/2006
Last updated
04/18/2011
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