Individual
IRENEJOY SANTOS SIMSUANGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
750 MIDDLE COUNTRY RD, MIDDLE ISLAND, NY 11953-2542
(631) 345-0065
(631) 345-0138
Mailing address
750 MIDDLE COUNTRY RD, MIDDLE ISLAND, NY 11953-2542
(631) 345-0065
(631) 345-0138
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
9046
NY
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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