Organization
YOUR OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARAT SHLIMOV (OPTICIAN)
17182651100
Entity
Organization
Contact information
Practice address
2849 W 8TH ST, BROOKLYN, NY 11224-3604
(718) 265-1100
Mailing address
2849 W 8TH ST, BROOKLYN, NY 11224-3604
(718) 265-1100
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007320
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02757495
—
NY
Enumeration date
11/07/2006
Last updated
04/23/2008
Update your record
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