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Individual

MR. MARK G MUSIAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTHALMIC DISPENSER

Contact information

Practice address
6928 MYRTLE AVE, GLENDALE, NY 11385-7263
(718) 381-4577
(718) 634-2540
Mailing address
260 BEACH 136TH ST, BELLE HARBOR, NY 11694-1324
(718) 945-0892
(718) 634-2540

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006109-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01612817
NY
Enumeration date
06/23/2006
Last updated
07/08/2007
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