Individual
IGOR KIZHNERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
16803 JAMAICA AVE, JAMAICA, NY 11432
(718) 657-4170
(718) 657-4171
Mailing address
16803 JAMAICA AVE, JAMAICA, NY 11432
(718) 657-4170
(718) 657-4171
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006787-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02256417
—
NY
Enumeration date
09/25/2006
Last updated
07/09/2007
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