Organization
MIRKIN VISION CARE PC
Active
Other names
Mirkin Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. DANIEL S MIRKIN O.D. (PRESIDENT)
(718) 634-0005
Entity
Organization
Contact information
Practice address
253 BEACH 116TH ST, ROCKAWAY PARK, NY 11694-2102
(718) 634-0005
(718) 474-2003
Mailing address
253 BEACH 116TH ST, ROCKAWAY PARK, NY 11694-2102
(718) 634-0005
(718) 474-2003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
004688
NY
332BC3200X
Customized Equipment (DME)
VUT004688
NY
332H00000X
Eyewear Supplier
VUT004688
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01126778
—
NY
Enumeration date
02/13/2006
Last updated
03/29/2010
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