Individual
BOAZ BEN-JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1445 HEMPSTEAD TPKE, ELMONT, NY 11003-2400
(516) 616-1771
Mailing address
1445 HEMPSTEAD TPKE, ELMONT, NY 11003-2400
(516) 616-1771
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007987
NY
Other
Enumeration date
03/10/2012
Last updated
03/10/2012
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