Individual
OLEG PETROGALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
77 GREEN ACRES RD, VALLEY STREAM, NY 11581-1008
(516) 612-0528
(516) 887-2565
Mailing address
77 GREEN ACRES RD, VALLEY STREAM, NY 11581-1008
(516) 612-0528
(516) 887-2565
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6702
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0710862119
—
NY
Enumeration date
12/15/2017
Last updated
12/15/2017
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