Individual
VICTORIA ROSE NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPHTHALMIC DISPENSER
Contact information
Practice address
199 MAIN ST, KEANSBURG, NJ 07734-1768
(347) 530-2403
(718) 966-9404
Mailing address
639 VETERANS RD W, STATEN ISLAND, NY 10309-1159
(347) 530-2403
(718) 966-9404
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
009771
NY
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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