Individual
DR. LUCIA PATINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
8114 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6746
(718) 505-9401
Mailing address
8114 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6746
(347) 858-2761
(718) 505-9403
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006595
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02828811
—
NY
01
—
G400000253
MEDICARE PTAN
NY
Enumeration date
08/31/2006
Last updated
07/21/2022
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