Individual
ANA LIZA BUAN-JACOMINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
2110 1ST AVE, #703, NEW YORK, NY 10029-3310
(212) 400-8477
Mailing address
2110 1ST AVE, #703, NEW YORK, NY 10029-3310
(212) 400-8477
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007989-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02554227
—
NY
Enumeration date
07/13/2007
Last updated
07/13/2007
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