Individual
MR. BORIS MULOKANDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16524 BAISLEY BLVD, STORE #14 MALL #1, JAMAICA, NY 11434-2517
(718) 276-0055
(718) 276-5059
Mailing address
16524 BAISLEY BLVD, STORE #14 MALL #1, JAMAICA, NY 11434-2517
(718) 276-0055
(718) 276-5059
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008669-1
NY
Other
Enumeration date
10/08/2009
Last updated
10/17/2014
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