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Individual

LILLIAN ELISA SANTANA-RESTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
274 W 125TH ST, ALL EYES ON US, INC., NEW YORK, NY 10027-4410
(212) 663-1511
(212) 663-1510
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUVOO4957
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02666535
NY
01
11510086
CAQH PROVIDER ID
NY
Enumeration date
09/20/2006
Last updated
04/09/2019
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