Individual
MISS VINCENT INDELICATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6819 18TH AVE, BROOKLYN, NY 11204-4416
(718) 236-6090
(718) 236-6090
Mailing address
6819 18TH AVE, BROOKLYN, NY 11204-4416
(718) 236-6090
(718) 236-6090
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C003893-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01105031
—
NY
Enumeration date
11/05/2007
Last updated
11/05/2007
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