Individual
DMITRIY ISRAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPHTHALMIC DISPENSER
Contact information
Practice address
1332 PENINSULA BLVD, HEWLETT, NY 11557
(516) 792-3013
(516) 792-3013
Mailing address
6607 99TH STREET 2A, REGO PARK, NY 11374
(516) 792-3012
(516) 792-3013
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008903
NY
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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