Individual
DR. DANIELLE POLVANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7051 AUSTIN ST, FOREST HILLS, NY 11375-4729
(718) 793-1200
Mailing address
6837 YELLOWSTONE BLVD APT D42, FOREST HILLS, NY 11375-3413
(718) 541-0852
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009442
NY
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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