Individual
LILLIAN ELISA SANTANA-RESTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
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
Update your record
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