Individual
BAHUR YACOBOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
8113 LEFFERTS BLVD, KEW GARDENS, NY 11415-1727
(718) 849-0847
(718) 849-0864
Mailing address
8113 LEFFERTS BLVD, KEW GARDENS, NY 11415-1727
(718) 849-0847
(718) 849-0864
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6538
NY
Other
Enumeration date
05/03/2012
Last updated
05/11/2012
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