Individual
CLARALIZ SANTOS UTATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4930 BROADWAY, NEW YORK, NY 10034-3182
(347) 720-0844
Mailing address
4930 BROADWAY, NEW YORK, NY 10034-3182
(347) 720-0844
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
000000
NY
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
04/28/2022
Last updated
08/01/2022
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