Individual
DR. NICKOLAS GEORGE VLANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5572 BROADWAY, BRONX, NY 10463-5216
(718) 884-4297
Mailing address
16005 23RD AVE, WHITESTONE, NY 11357-3938
(718) 357-5458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005473-1
NY
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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